骨髓巨核细胞数对小儿特发性血小板减少性紫癜预后的影响

Prognostic Significance of Megakaryocyte Number in Children with Idiopathic Thrombocytopenic Purpura

目的:探讨骨髓巨核细胞数对判断小儿特发性血小板减少性紫癜(ITP)预后的意义。方法:计数ITP患儿治疗前骨髓巨核细胞数,并将其分为巨核细胞数正常组和巨核细胞数增多组,给予相同的治疗方案,并随访1年。结果:50例患儿治疗后,巨核细胞数正常组77.8%(21/27例)于2周内达完全反应,而巨核细胞数增多组仅39.1%(9/23例)在2周内达完全反应。经统计学处理,两组有非常显著性差异(x~=7.72,P<0.01)。血小板计数在4周恢复正常者,巨核细胞数正常组为85.1%(23/27例),巨核细胞数增多组为56.5%(13/23例),两组有显著性差异(x^2=5.07,P<0.05)。随访1年,8例转为慢性(CITP),其中巨核细胞数正常组2例,巨核细胞数增多组6例。结论:治疗前骨髓巨核细胞数可作为早期判断小儿ITP预后的一个有效的指标,明显增多者提示转为CITP的危险性增高。

Objective:To investigate the prognostic significance of bone marrow megakaryocyte number in children with idiopathic thrombocytopenic purpura (ITP). Methods:Fifty patients were divided into two groups which included normal (group 1) and abnormal (group 2) number of megakaryocyte groups according to megakaryocyte counting, and received the same treatment with the follow-up of 1 year. Results: The complete remission was 77.8 % in group 1 and 39.1% in group 2 two weeks after treatment (x2 =7.72,P<0.01). The complete remission rates of platelet in group 1 and group 2 were 85.1 % and 56.5% respectively ( x2 =5.07,P<0.05).Eight patients developed to CITP,2 cases were from group 1,and 6 from group 2. Conclusion: Bone marrow megakaryocyte number is a valuable marker in prognosis of ITP.