血小板减少症患者血小板参数检测的临床意义

Clinical Significance of Platelet Indices in Patients with Thrombocytopenia

目的探究血小板减少症患者血小板参数的变化及其临床意义。方法采用SysmexXE-2100全自动五分类血液分析仪检测83例不同类型血小板减少症患者,包括24例急性白血病(AL),28例骨髓增生异常综合征(MDS)和31例特发性血小板减少性紫癜(ITP)病人治疗前后血小板计数(PLT)、血小板比积(PCT)、平均血小板体积(MPV)和血小板分布宽度(PDW),并将检测结果与正常对照组进行比较。结果初诊时ITP、AL和MDS患者的PLT和PCT明显低于正常对照组(P<0.01),其中ITP患者的MPV和PDW明显高于AL、MDS患者以及正常对照组(P<0.01),AL和MDS患者的PDW也明显高于正常对照组(P<0.01),但二者的MPV值与正常对照组比较无明显差异。ITP、AL和MDS患者缓解后PLT和PCT明显上升,而PDW下降,与未缓解组比较有显著差异(P<0.01),ITP缓解组的MPV明显低于未缓解组(P<0.01),而AL和MDS缓解组的MPV值与未缓解组比较无显著差异。结论血小板参数的检测对于明确血小板减少的病因及其预后具有重要临床意义。

Objective To investigate the clinical significance of the platelet indices in the spectrum of thrombocytopenia. Methods A total of 83 patients with thrombocytopenia were studied, including 31 cases with idiopathic thrombocytopenia purpura （ITP） and 24 patients with acute leukemia （AL） as well as 28 myelodysplasia syndrome （MDS）cases. The platelet indices-platelet count （PLT）, plateletcrit （PCT）, mean platelet volume （MPV）and platelet distribution width （PDW）- were measured by Sysmex XE-2100 automated blood cell analyzer. The platelet indices in these patients before and after treatment were further analyzed and statistically compared with healthy controls. Results That PLT and PCT were significantly lower in patients with ITP,AL and MDS in comparison with the control group （P 〈0.01 ）. In particular, MPV and PDW were significantly higher in patients with ITP compared with those with AL and MDS as well as the control group （P 〈 0.01 ）. Additionally, PDW were significantly raised in patients with AL and MDS compared with the control group （P 〈 0.01 ）. There was no significant difference in MPV values among AL, MDS and control groups. Furthermore, PLT and PCT were found to be elevated combined with PDW decreased in patients with ITP, AL and MDS in remission or clinical improvement. Meanwhile, MPV was dramatically decreased in ITP cases in clinical remission or improvement. However, MPV showed little difference in AL and MDS patients in remission compared with those being resistant to therapy. Conclusion The platelet indices could provide important clinical information about the underlying conditions and prognosis of thrombocytopenia.