未成熟血小板分数在血小板减少性疾病中的变化

The variation of immature platelet fraction in patients with thrombocytopenic diseases

目的了解血小板减少性疾病患者外周血未成熟血小板分数(IPF)、高荧光强度未成熟血小板分数(H-IPF)、未成熟血小板绝对值(IPF#)和血小板平均侧向荧光强度(PLT-X)的变化,探讨其在血小板减少性疾病中的临床意义。方法选取血小板减少性疾病86例[特发性血小板减少性紫癜(ITP)50例、再生障碍性贫血(AA)15例、急性白血病(AL)21例]、骨髓增生性疾病(MPD)32例[慢性粒细胞白血病(CML)11例、原发性血小板增多症(ET)16例、真性红细胞增多症(PV)5例]和健康对照者50名。应用SYSMEX XE-5000全自动血液分析仪检测各疾病组及健康对照组外周血血小板(PLT)、IPF、H-IPF、IPF#和PLT-X。将ITP组按PLT计数结果分为≤30×109/L、(>30～<60)×109/L、(60～<100)×109/L 3组,并比较各组IPF。结果 ITP组IPF、H-IPF、IPF#和PLT-X测定值分别为(19.8±12.7)%、6.7(4.7～12.3)%、3.1(2.0～12.1)×109/L和(27.8±8.6)ch;AA组IPF、H-IPF、IPF#和PLT-X测定值分别为(5.6±2.5)%、1.9(0.7～4.0)%、0.8(0.4～1.4)×109/L和(17.3±2.4)ch;AL组IPF、H-IPF、IPF#和PLT-X测定值分别为(6.3±3.4)%、2.1(1.2～4.1)%、2.4(1.5～3.2)×109/L和(18.7±3.0)ch;MPD组IPF、H-IPF、IPF#和PLT-X测定值分别为(3.1±1.6)%、2.1(0.9～0.7)%、19.2(14.0～22.5)×109/L和(16.9±2.3)ch;健康对照组IPF、H-IPF、IPF#和PLT-X测定值分别为(4.1±1.3)%、1.2(1.0～1.7)%、9.3(7.4～12.1)×109/L和(18.4±1.5)ch。ITP组IPF、H-IPF和PLT-X明显高于AA组、AL组、MPD组和健康对照组(P<0.05);ITP组IPF#与AA组、AL组、MPD组比较差异均有统计学意义(P<0.05),和健康对照组比较差异无统计学意义(P>0.05)。ITP各组间IPF差异无统计学意义(P>0.05)。结论检测血小板相关参数(IPF、H-IPF和PLT-X)可能有助于血小板减少性疾病的鉴别诊断。

Objective To investigate the variation of immature platelet fraction （IPF）, high-fluorescence intensity of immature platelet fraction （H-IPF）, absolute value of immature platelet （IPF#） and mean side fluorescence intensity of platelet（PLT-X） in patients with thrombocytopenic diseases and their clinical significance in the thrombocytopenic diseases. Methods The platelet （PLT）, IPF, H-IPF, IPF# and PLT-X of peripheral blood in 86 patients with thrombocytopenic diseases [50 cases of idiopathic thromboeytopenic purpura （ITP）, 15 cases of aplastic anemia （AA） and 21 cases of acute leukemia （AL）], 32 patients with myeloproliferative disorders （MPD） [ 11 cases of chronic myelogenous leukemia （CML）, 16 cases of essential thrombocythemia （ET） and 5 cases of polycythemia vera （PV）] and 50 healthy subjects were determined by automatic hematology SYSMEX XE-5000 analyzer. According to the results of PLT, the 50 cases of 1TP were classified into ≤30×109/L, （ 〉 30- 〈 60） ×109/L and （60- 〈 100） ×109/L groups, and the results for IPF were compared. Results The IPF, H-IPF, IPF# and PLT-X in ITP group were （ 19.8 ± 12.7） % ,6.7 （4.7-12.3） % ,3.1 （2.0-12.1） ×109/L and （27.8 ± 8.6 ） ch, respectively. The IPF, H-IPF, IPF# and PLT-XinAAgroup were （5.6 ±2.5）%,1.9（0.7-4.0）%,0. 8（0.4-1.4） x 109/L and （17. 3 ±2.4） ch, respectively. The IPF, H-IPF,IPF# and PLT-X in AL group were （6.3 ± 3.4）% ,2.1 （1.2-4.1）% ,2.4 （1.5-3.2） ×109/L and （ 18.7 ± 3.0） oh, respectively. The IPF, H-IPF, IPF# and PLT-X in MPD group were （ 3. 1 ± 1.6 ） % , 0.9 （0.7-1.4） %, 19.2 （ 14.0-22.5 ） ×109/L and （ 16.9 ± 2.3 ） eh, respectively. The IPF, H-IPF, ｜PF# and PUI＇-X in healthy subject group were （4. 1±1.3）%,1.2（1.0-1.7）%,9.3（7.4-12. 1） ×109/L and （18.4 ±1.5） eh, respectively. Compared with the AA, AL, MPD groups and healthy subject group,the IPF, H-IPF and PLT-X of ITP group were higher （ P 〈 0.05 ） , and the difference in the IPF# between ITP group and the other 3 groups was significant （P 〈 0. 05 ）, but there was no statistical significance in the IPF# between ITP group and healthy subject group （P 〉 0. 05 ）. There was no statistical significance for IPF in the ditterent groups of ITP （ P 〉 0. 05 ）. Conclusions It is possibly helpful for the differential diagnosis of thromboeytopenic diseases to measure the platelet relevant parameters （IPF, H-IPF and PLT-X） of peripheral blood.