血小板减少的系统性红斑狼疮患者骨髓巨核细胞数量与临床特点的关系

The impact of bone marrow megakaryocyte to clinical and immunological characteristics of thrombocytopenia in systemic lupus erythematosus

目的分析血小板减少的系统性红斑狼疮（SEE）患者的临床、实验室特点，探讨骨髓巨核细胞数量对患者临床特征的影响。方法回顾性分析北京大学人民医院住院102例血小板减少的SLE患者，以无血小板减少的140例SLE患者为对照，比较2组在器官受累、疾病活动度、骨髓象、免疫学特征及疗效方面的差别。统计学方法采用r检验和t检验。结果75例患者血小板减少发生在SLE确诊前后1年之间。血小板减少发生在SLE确诊前的患者中，血小板下降程度更为显著。有血小板减少的SLE患者脏器受累比例较高，主要包括神经系统和肺，但2组在总体SLE疾病活动指数（SLEDAI）评分方面的差异无统计学意义。根据骨髓巨核细胞数量分组，16例患者巨核细胞减少，无巨核细胞减少的患者34例。巨核细胞减少组的患者无论在疾病活动度、脏器受损等临床特点方面与无巨核细胞减少组差异无统计学意义。血小板减少的近期治疗效果也与骨髓巨核细胞数量无相关性。结论合并血小板减少的SLE患者容易合并其他重要脏器受损。

Objective To investigate the clinical significance of thrombocytopenia in systemic lupus erythematosus （SLE）. Methods One hundred and two SLE patients with thrombocytopenia who were admitted to Peking University People＇s Hospital were involved in the study. SLE patients without thrombocytopenia were controls. Clinical and laboratory characteristics were analyzed. Ttest and Chisquare test were used for intergroup comparison. Results Patients with thrombocytopenia had more organ damage than those without, although the disease activities （SLEDAI） were not different between these two groups. Bone marrow characteristics were analyzed and 16 patients were amegakaryocytic. However, there were no differences observed between patients with amegakaryocytosis and normal megakaryocytes in organ damage, disease activity and response to therapy. Conclusion Lupus patients with thrombocytopenia usually have more organ damage. About 32% of those patients are amegakaryocytosis.