流式细胞术检测网织血小板在临床上的应用

Meature of Reticulated Platelets by Flow Cytometer in Clinical Application

目的:探讨血小板减少症患者外周血中网织血小板(reticulated platelets,RP)百分率改变的临床意义.方法:用噻唑橙(TO)染色法流式细胞仪检测RP百分率,测定20例正常人和30例各种血小板减少症患者(包括ITP 3例,TTP 1例,AA 7例,未治疗白血病4例,白血病缓解期5例)RP百分率.结果:20例正常人RP百分率和RP绝对值分别为3.66±2.27%和7.78±4.53×109/L;ITP或TTP组分别为21.04±12.73%和4.36±3.09×109/L,RP百分率较正常对照组明显增高,差异具有显著性(P＜0.01).AA组和急性白血病初发组的RP百分率和RP绝对值分别为2.71±1.32%、0.75±0.48×109/L和2.51±1.45%、0.64±0.42×109/L,RP百分率较正常对照组轻度减低,差异无显著性(P＞0.05).白血病缓解组RP百分率无明显改变.结论:RP反映骨髓血小板生成能力,检测RP百分率有助于对血小板减少症病因的鉴别,特别是鉴别骨髓造血减少和外周血血小板破坏增多所致的血小板减少,并可作为疗效观察指标.

Objective: To explore the significance of reticulated platelets (RP) in the thrombocy-topenia. Methods: Reticulated platelets were stained with thiazole orange(TO) and measured by detected flow cytometer in 20 controls and 30 patients with thrombocytopenia(including 13 cases of ITP, 1 case of TTP, 7 cases of AA, 4 cases of untreated luekemia and 5 cases of leukemia in remision). Results: The percentage and absolute value of RP were 3.66±2.27% and 7.78±4.53×109/L in 20 controls, 21.04±12.73% and 4.36±3.09×109/L in patients with ITP or TTP, 2.71±1.32% and 0.75±0.48×109/L in aplastic anemia, 2.51±1 .45% and 0.64±0.42×10 /L in untreated luekemia. To compare with control group, RP% were markedly elevated in the patients with ITP or TTP( P >0. 05), and were light decreased in patients with AA and untreated luekemia, but no significance was founded( P >0. 05) . RP% in patients with luekemia in remision was same as control. Conclusion: RP can reflex the ability of bone marrow thrombocytopoiesis, RP% would be helpful for distinguish thrombocytopenia, easpecially in hypopro-liferation and hyperdestruction of platelets, and was useful in preceding the recovery of platelets.