网织血小板检测方法的改良及临床应用

IMPROVEMENT AND CLINICAL APPLICATION OF RETICULATED PLATELET DETECTION

目的改良网织血小板(RP)检测方法并探讨其临床应用价值。方法以噻唑橙(TO)作为RNA的荧光染料,利用流式细胞仪检测30例正常人(正常对照组)和48例各种血小板减少症外周血中含有RNA的RP百分数及RP绝对值,后者包括原发性血小板减少性紫癜(ITP)、再生障碍性贫血病人(AA)及初治急性白血病病人。结果ITP病人RP百分数明显高于正常对照组(F=65.29,q=10.26,P<0.01),而RP绝对值明显低于正常对照组(F=85.07,q=19.59,P<0.01);AA病人RP百分数及绝对值均低于正常对照组(q=3.47、16.41,P<0.05、0.01);AL组病人RP百分数与正常对照组比较无明显差异(q=0.51,P>0.05),但其RP绝对值明显低于正常对照组(q=15.46,P<0.01)。结论改良了传统的网织血小板检测方法并建立了简便、稳定的检测手段,为临床各类血小板减少性疾病的诊断提供了可靠的方法。

Objective To improve the measurement of reticulated platelets （RPs） and to explore its clinical application. Methods Using thiazole orange as a fluorescent dye, RPs were measured by analyzing the RNA content in platelets in 30 normal controls and 48 various thrombocytopenia, i.e. idiopathic thrombocytopenic purpura （ITP）, aplastic anemia （AA）, and initiallytreated acute leukemia （AID, with flow cytometry. The percentage and absolute value of RPs were calculated. Results Compared with the normal group, ITP patients had a significantly high percentage （F= 65. 29,q= 10. 26, P〈0. 01 ） and low absolute value of RPs （F=85. 07,q= 19.59,P〈0.01） ; in AA, both the percentage and absolute value of RPs were at low levels （q= 3.47, 16. 41; P〈0.05,0.01）. There was no difference of RP percentage between the AL and normal controls （q= 0.51, P〉0.05）, but the absolute value of RPs in AL was significantly lower than the control （q= 15. 46, P〈0. 01）. Conclusion The traditional method of reticulated platelet detection has been improved and a simple and stable one established, which provides a reliable method for diagnosis of various thrombocytopenia.