血小板参数在妊娠期首发血小板减少诊断与鉴别诊断中的价值

The value of platelet parameters in the diagnosis and differential diagnosis of pregnancy-emerged thrombocytopenia

目的：探讨血小板参数在妊娠期首发血小板减少诊断与鉴别诊断中的价值。方法选取110例妊娠期首发血小板减少（PLT＜100×109/L）患者，根据病因分为妊娠相关性血小板减少（PAT）组77例、特发性血小板减少性紫癜（ITP）组18例和溶血、肝酶升高、血小板减少综合征（HELLP）组15例，另选取正常妊娠妇女110名为对照组，观察四组外周血中血小板参数的变化情况并作比较分析。结果 PAT组、HELLP组与正常妊娠组比较，PLT下降，差异有统计学意义（P＜0.05），MPV、PDW、PCT差异无统计学意义（P＞0.05）。ITP组与正常妊娠组以及PAT组、HELLP组比较，MPV、PDW上升，PLT、PCT下降，差异有统计学意义（P＜0.05）。结论观察PLT、MPV、PDW、PCT等血小板参数的变化情况有助于鉴别诊断妊娠期首发血小板减少的原因。

Objective To explore the value of platelet parameters in the diagnosis and differential diagnosis of pregnancy-emerged thrombocytopenia .Methods The variation of platelet parameters of 110 cases of thrombocyto-penia in pregnancy （ PLT〈100 ×10 9/L） and 110 health controls were analyzed retrospectively .Among the 110 cases of thrombocytopenia in pregnancy , 77 were diagnosed having pregnancy-associated thrombocytopenia （ PAT）;18 had idiopathic thrombocytopenic purpura （ITP）;15 had hemolysis,elevated liver enzymes,and low platelets（HELLP）.Re-sults The levels of PLT in PAT group or HELLP group were lower than that in the healthy controls ,the difference were statistically significant （ P〈0.05 ） .The levels of PCT , MPV or PDW in PAT group and HELLP group did not change when compared with those in healthy controls （ P〉0.05 ）;The levels of MPV and PDW were higher and the levels of PLT and PCT were lower in ITP group than those in the healthy controls ,PAT group or HELLP group , the differences were statistically significant （ P〈0.05 ） .Conclusion As the basis of the differential diagnosis the detec-ting of platelet parameters （ PLT, MPV, PDW, PCT） can be helpful in the identification of the cause of pregnancy-e-merged thrombocytopenia .