ITP患者血小板计数和出血分级之间关系的临床研究

目的探讨特发性血小板减少性紫癜（ITP）患者血小板计数与出血分级之间关系。方法采用ITP出血分级标准对123例ITP患者的424例次出血事件的评估，采用X^2检验比较ITP患者的血小板计数的程度及时长的不同分组的严重出血（2级出血）发生率的关系。ITP患者依据血小板计数分成A组（20-30）×10^9／L、B组（10～20）×10^9/L儿和C组（0～10）×10^9／L，同时依据天数分成7组，共计21小组。结果血小板减少≥4d的C组与B组的严重出血的发生率之间差异有统计学意义（P〈0．05），而〈3d的B组和A组的严重出血的发生率之间差异有统计学意义（P〈0．05）。结论ITP患者〈3dPLT下降至≤20×10^9／L或〉4dPLT下降至≤10×10^9／L时，容易发生严重出血，故可作为ITP患者输注血小板的指征。

Objective To explore the relationship between platet count and bleeding grading in patients with idiopathicthrombocytopenic purpura（ITP）. Methods Bleeding grading was developed for 123 ITP patients with 424 bleeding accidences by means of ITP bleeding grading standard, the relationship between platelet count and severe bleeding（ the 2nd Bleeding grading） incidence rate was analyzed by means of 2 test. ITP patients were divided into group A（20 -30 ×10^9/L） ,groupB （ 10-20× 10^9/L） and groupC（0-10× 10^9/L） by platelet count,and were divided into 7 groups by day,total21 branch groups. Results There was significant difference in severe bleeding incidence rate between the B group and C group when platelet count declined for more than 4 days, and there was significant difference of severe bleeding incidence rate between the A group and B group when platelet count declined in 3 days in ITP. Conclusions There is more severe bleeding incidence rate when platelet count ≤ 10 ×10^9/L for more 4 days or≤20 ×10^9/L in 3 days in ITP,which can be taken as indication for platelet infusion.