肺结核患者血小板计数的临床研究

Clinical Research of Platelet Count in Pulmonary Tuberculosis

目的通过分析肺炎,肺结核及健康成人血液中的血小板计数,探讨肺结核患者血小板计数的特点,以及血小板与其他急性时相反应物和影像学的关系。方法随机选取180例患者,其中肺结核组80例、肺炎组50例、健康成人组50例、分别检测3组患者血液中的血小板计数、血沉、血CRP(C反应蛋白)、白细胞及血红蛋白。结果肺结核组和肺炎组的白细胞、血沉及血CRP比健康成人组升高,肺结核组的白细胞、血沉及血CRP比肺炎组低,而血小板计数比肺炎组高(P<0.001)。血小板计数在肺结核患者中与血沉、血CRP有相关性(P<0.001),而在肺炎患者中无相关性(P>0.05)。血沉、血CRP、血小板计数与肺部病灶多少有关,肺部病灶越多,血沉、血CRP、血小板的计数越高,而血红蛋白则相反(P<0.05)。在血小板增多症的肺结核患者中,血沉、血CRP比血小板正常的肺结核患者要明显升高。结论本研究结果提示在肺结核患者中,血小板出现反应性增多,血小板增多与急性时相反应物有关联,而且影像学上病灶多的患者,血小板增多更常见,所以应该重视血小板在肺结核患者的细胞免疫过程中所起的作用。

Objective To analyze platelet count in pulmonary tuberculosis,pneumonia and healthy individuals,to explore the fea- tures in tuberculosis and the relations of platelet count with other acute phase reactants and radiological extent in pulmonary tuberculosis. Methods Eighty patients with pulmonary tuberculosis （Group 1 ） ,50 patients with community acquired pneumonia （ Group 2） and 50 healthy individuals （ Group 3 ） were included in this study. Then platelet （ PLT count） , white blood cell（ WBC ） , eritrocyte sedimeatation rate （ESR）and c -reactive protein （CRP） were detected. Results WBC,ESR,CRP and PLT values were higher in Group 1 and Group 2 than in Group 3. WBC, ESR, and CRP values were lower,while PLT value was higher in the Group 1 compared to Group 2 （P 〈 0. 001 ）. PLT was positively correlate with CRP and ESR values in the tuberculosis group（ P 〈 0. 001 ） , while it was not correlated with CRP and ESR in the pneumonia group（P 〉 0.05 ）. ESR, CRP and PLT values were found to be higher in radiological advanced stage （stage 3 ）pa- tients with PTB, while hemoglobin（HB） was found lower（ P 〈 0.05 ）. Higher WBC, ESR and CRP values were more commom in PTB pati- enets with thrombocytosis compared to the patients with normal platelet count,whereas Hb was found lower in these patients. Conclusion This study indicates that reactive thrombocytosis frequently in PTB,and there is a relation between thrombocytosis and acute ohase reaetan- gts. In addition,tuberculusis with radiological advanced stage is seen more frequently in the patients with thrombocytosis. So we should pay attention to the possible role of platelets in the cell - based immune process of tuberculusis.