血浆TPO水平变化与血小板减少疾病的关系

The relationship between levels of plasma thrombopoietin and thrombocytopenia

目的:探讨血浆血小板生成素(Thrombopoietin,TPO)水平变化与血小板减少疾病的关系。方法:采用多抗夹心酶联免疫吸附法对68例各种不同原因致血小板减少患者通过应用白介素-11(rhIL-11)来动态检测TPO水平,rhIL-11剂量为25μg/(kg.d),皮下注射,连用10天。结果:(1)急性白血病(Acute leukemia,AL)化疗后血小板减少患者TPO水平低于正常对照组;再生障碍性贫血(Aplastic anemia,AA)及骨髓增生异常综合征(Myelodysplastic syndrome,MDS)患者TPO水平高于正常对照组;原发性血小板减少性紫癜(Idiopathic thrombocytopenic purpura,ITP)及肝硬化(Liver cirrhosis)患者TPO水平与正常对照组无明显差异。而其中的白血病化疗后血小板减少患者和AA患者的骨髓巨核细胞数较TPO正常组显著降低。(2)上述疾病患者用rhIL-11有效者TPO水平趋于正常,无效或疗效欠佳者,则TPO无变化。有效者TPO水平与血小板计数呈负相关。结论:血浆TPO检测,有助于临床鉴别各种血小板减少疾病的病因,对血小板减少患者合理应用rhIL-11提供理论的依据。

Objective：To investigate the relationship between levels of plasma thrombopoietin （TPO） and thrombocytopenia. Methods：Sixty-eight thrombocytopenia with different causes were injected with rhIL-11 domestically made, by 25μg/（kg · d） for 10 days continuously. The plasma TPO levels were determined by quantitative sandwich enzyme immunoassay technique in thrombocytopenic patients between before and after treatment. Results： （ 1 ） The serum TPO controls of patients with thrombocytopenia after acute leukemia（AL） chemotherapy were lower than normal controls. The plasma TPO levels in aplastic anemia（AA） and myelodysplastic syndrome（MDS） patients were all elevated compared to those in normal controls. The serum TPO levels in patients with idiopathic thrombocytopenic purpura（ITP） and liver cirrhosis had no difference with the normals. Bone marrow megakaryocytes（MK） count in after chemotherapy AL and AA patients were lower than those with normal serum TPO levels controls. （2）In all above patients used interleukin-11 （ rhIL-11 ） , their TPO levels were close to normal in efficiency patients. On the contrary, their TPO did not change dramatic. Those react to rhIL-11, their TPO levels were inversely correlated with platelet count. Conclusion ：Testing serum TPO levels would be helpful for distinguish the thrombocytopenia with different causes, and provides theorical support to patients to use rhIL-11 reasonably.