高胆红素血症合并反应性血小板增多症新生儿血小板参数分析

Analysis on platelet parameters of neonates with hyperbilirubinemia combined with reactive thrombocytosis

目的:探讨高胆红素血症合并反应性血小板增多症新生儿的血小板参数和白细胞的变化及与黄疸程度的关系。方法:采用全自动血细胞分析仪测定354例高胆红素血症新生儿和36例正常新生儿的血小板计数(PLT)、血小板体积(MPV)、血小板分布宽度(PDW)、白细胞计数(WBC)。按黄疸程度分为轻度、中度、重度3组,比较反应性血小板增多症的发生率;按有无反应性血小板增多症分为反应性血小板增多症组和非反应性血小板增多症组,比较血小板参数和白细胞的变化。结果:354例高胆红素血症新生儿中合并反应性血小板增多症32例,发生率为9.04%,不同程度高胆红素血症新生儿反应性血小板增多症发生率比较差异无统计学意义(P>0.05)。高胆红素血症新生儿反应性血小板增多症组MPV高于高胆红素血症新生儿非反应性血小板增多症组(t=0.551,P<0.05),两组PDW、WBC比较差异均无统计学意义(P>0.05)。结论:高胆红素血症新生儿合并反应性血小板增多症时提示骨髓巨核细胞处于增生状态,其发生率与黄疸的程度无关。

Objective： To explore the changes of platelet parameters and white blood cells in neonates with hyperbilirubinemia combined with reactive thrombocytosis and their relationships with the degree of jaundice. Methods： Automatic blood cell analyzer was used to detect the values of blood platelet count （PLT）, mean platelet volume （MPV）, platelet distribution width （PDW）, and white blood cell count （WBC） of 354 neonates with hyperbilirubinemia and 36 neonates with normal bilirubin level. The neonates with hyperbilirubinemia were divided into mild jaundice group, middle jaundice group, and severe jaundice group, the incidence rates of reactive thrombocytosis in the three groups were compared; the neonates were divided into reactive thrombocytosis group and non - reactive thrombocytosis group ac- cording to combining with reactive thrombocytosis or not, the changes of platelet parameters and white blood cells were compared. Results： Among 354 neonates with hyperbilirubinemia, 32 neonates were found with reactive thrombocytosis, the incidence rate of reactive thrombocy- tosis was 9.04%, there was no statistically significant difference in the incidence rate of neonatal reactive thrombocytosis among mild jaun- dice group, middle jaundice group, and severe jaundice group （ P 〉 0. 05 ） . MPV in reactive thrombocytosis group was statistically signifi- cantly higher than that in non- reactive thrombocytosis group （t=0. 551, P 〈 0. 05 ）, but there was no statistically significant difference in PDW and WBC between the two groups （P 〉 0. 05） . Conclusion ： ,Hyperbilirubinemia combined with reactive thrombocytosis in neonates indicates that bone marrow megakaryocytes are in hyperplastic condition, and the incidence rate is not related to the degree of jaundice.