特发性血小板减少性紫癜患者巨核细胞及血小板参数变化的分析

Analysis of megakaryocytes and platelet parameter change in idiopathic thrombocytopenic purpura

[目的]探讨骨髓巨核细胞和血小板参数对特发性血小板减少性紫癜（ITP）的临床意义。[方法]回顾性分析2006年3月-2008年12月在大连医科大学附属第二医院诊治的85例ITP患者的血小板（PLT），血小板平均体积（MPV），大血小板比率（P—LCR），血小板平均分布宽度（PDW）及骨髓巨核细胞（MK）的变化。[结果]ITP组PDW增高（16．91±1．06）11，与对照组比较有显著意义（P〈0．05）；ITP组的MPV增高（9．87±1．35）n，与对照组比较有非常显著的意义（P〈0．001）；并且随着病情的进展，MPV逐渐增高，PDW减低；骨髓巨核细胞数与血小板减低没有相关性。在ITP的治疗过程中，MPV比PLT更早出现明显升高。[结论]ITP发病的免疫机制比较复杂，动态观察血小板参数对其诊断和疗效观察有非常重要的意义。

[ Objective] This is a study of clinical significance of megakaryocytes and platelet parameters in Idiopathic Thrombocytopenic Purpura （ITP）. [ Methods] We retrospectively analyzed changes of PLT, MPV, P -LCR, PDW and bone marrow megakaryocyte in 85 ITP patients in the hospital from Mar. 2006 to Dec. 2008. [ Results ] PDW increased （16.91 ± 1.06）fl and PLT decreased in ITP, which was significant difference from control （P 〈 0.05 ）. MPV increased （9.87 ± 1.35）fl evidently in ITP （P 〈 0. 001 ）. With the development of ITP, MPV increased and PDW decreased. Bone marrow megakaryocyte number had no correlation with the decrease of PLT. [ Conclusion] The immunological mechanism of ITP onset is very complex. The dynamic observation of PLT parameters is important in the diagnosis and tracking the thera- peutic effect of ITP.