特发性血小板减少性紫癜血小板生成素的测定及其临床意义

Serum thrombopoietin levels in patients with idiopathic thrombocytopenic purpura and its significance

目的研究特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)患者血清血小板生成素(thrombopoientin,TPO)水平改变与疗效的关系。方法选取我院45例ITP患者(ITP组)和25例体检正常者(对照组),应用酶联免疫吸附法定量检测2组患者治疗前后TPO浓度,同时分别采用血细胞分析仪及骨髓涂片法检测治疗前后ITP患者外周血血小板和骨髓巨核细胞的数量,并根据治疗1个月后患者的疗效情况,将ITP患者分为治疗有效组和治疗无效组。结果 ITP组与对照组相比,血小板计数及巨核细胞计数差异显著,具有统计学意义(P<0.05),而TPO浓间差异无显著性,不具有统计学意义(P>0.05);治疗前,ITP组中治疗无效组的TPO浓度明显高于治疗有效组和对照组(P>0.05),而巨核细胞计数明显低于治疗有效组和对照组。结论血清TPO水平在ITP患者预后判断中具有重要意义。

Objective To investigate serum thrombopoietin （TPO） levels in patients with idiopathic thrombocytopenic purpura （ITP） and its significance. Methods The serum levels of thrombopoietin in ITP patients （ n = 45 ） and healthy subjects （ control group, n = 25 ） were tested by sandwich enzyme-linked immunosorbent assay. The peripheral platelet counts were measured by automatic hemocyte analyzer; and the bone marrow megakaryocytes were counted directly under microscope. Among 45 ITP patients, 37 were responders and 8 were non-responders to treatment. Results The counts of platelets in ITP patients significantly decreased （P 〈0.05）; and the counts of megakaryocytes increased （ P 〈 0.05）. However, there was no significantly difference in serum TPO levels between ITP patients and control group. The TPO levels of responder ITP patients were significantly higher than those of non-responders and healthy controls （ P 〈 0.05 ） ; The megakaryocyte counts of non-responder patients were significantly lower than that of patients in responders（P 〈0.05）. Conclusion The serum levels of thrombopoietin may be a useful indicator for effectiveness of treatment.