巨核细胞形态学改变和特发性血小板减少性紫癜治疗的关系

relationship between morphological changes of megakaryocytes and treatment of idiopathic thrombocytopenic purpura

目的探讨成人特发性血小板减少性紫癜(ITP)与骨髓巨核细胞的关系及其治疗时的形态学改变。方法回顾性分析52例ITP患者的临床资料、实验室检查及治疗效果,就骨髓巨核细胞的数量、退化变性、颗粒、细胞胞浆量与36例健康者进行定量比较分析。结果 ITP患者巨核细胞数明显增加,颗粒减少伴成熟障碍,胞浆量增多,退化变性增加,与对照组比较有显著性差异(P均<0.05)。治疗前血小板数与疗效无明显关系(P>0.05),但治疗前巨核细胞数增加或正常者效果明显优于巨核细胞数减少者(P均<0.05)。结论骨髓巨核细胞的形态学改变对诊断ITP有重要意义。肾上腺皮质激素治疗效果与巨核细胞数相关,巨核细胞数增加或正常者疗效较好。

Objective It is to investigate the relationship between bone marrow megakaryocytes and the adult idiopathic thrombocytopenic purpura（ITP） and the morphological changes during treatment.Methods A retrospective analysis of 52 cases of ITP in patients with clinical data,laboratory examination and treatment to the number of bone marrow megakaryocytes,degeneration,granular,cytoplasmic volume,and 36 healthy persons were compared with quantitatively analysis.Results The megakaryocytes count in patients with ITP was significantly increased,and number of particles was reduced and associated with maturatin disturbance,and cytoplasm capacity was increased,and retired shape variability was increased,there was significant difference compared with control group（P0.05）.There was no significant difference in relationship between platelet count before treatment and effect（P0.05）,but the curative effect with increasion and normal of megakaryocytes count was better than that with reduction（P0.05）.Conclusion Bone marrow morphological changes of megakaryocytes are important for diagnosis of ITP.Effect of adrenal cortex hormone therapy is related to megakaryocytes count,patients with count increasion or normal may have good effect.