网织血小板和PLT计数在SLE患者诊疗中的临床应用价值

Clinical value of reticulated platelet and platelet count for diagnosis and treatment of systemic lupus erythematosus

目的：探讨网织血小板（RP）和血小板（PLT）计数在系统性红斑狼疮（systemic lupus erythematosus,SLE）患者诊疗中的临床应用价值。方法：筛选出确诊的SLE患者103例,采用XE-5000血细胞分析仪流水线进行血液中血小板计数分析,并根据血小板降低的严重程度,将SLE患者分为SLE伴血小板轻度降低组[（71~100）×10~9/L]、血小板中度降低组[（41~70）×10~9/L]、血小板重度降低组[（20~40）×10~9/L]和危急值组[（0~20）×10~9/L]。健康体检者40例为对照组进行检测。采用CD61-PE单抗标记血小板,噻唑橙（TO）为染料,应用富含血小板血浆（platelet-rich plasma,PRP）法检测RP%,对其中20例危急值组的SLE患者进行糖皮质激素治疗前后的RP%检测。结果：血小板危急值组、重度降低组和血小板中度降低组3组RP%均显著高于对照组（P〈0.05）;血小板危急值组、重度降低组和血小板中度降低组的RP%显著高于血小板轻度降低组（P〈0.05）;血小板轻度降低组和对照组比较差异无统计学意义（P〉0.05）。20例SLE伴血小板危急值组患者治疗前后的RP%分别为（5.86±2.59）%和（3.14±1.97）%,二者比较差异有统计学意义（P〈0.05）。结论：RP%可能成为评估SLE患者血小板活性的新指标,其值的高低可以反映出骨髓血小板的生成情况,有助于SLE的辅助诊断和预后判断。

Objective To explore the significance of reticulated platelets（RP） and platelet count for the diagnosis and treatment of systemic lupus erythematosus（SLE）.Methods Totally 103 cases of diagnosed SLE patients underwent blood platelet count with XE-5000 hematology analyzer,and then divided into four groups according to platelet count,including the group with lightly decreased platelet count[（71-100）×10~9/L],the group with moderately decreased platelet count[（41-70）×10~9/L],the group with heavily decreased platelet count [（20-40） ×10~9/L] and the group with critical platelet count [（0-20） ×10~9/L].There were 40 healthy persons enlisted into a control group.The platelet was marked with monoclonal antibody CD61-PE and dyed with thiazol orange,and the method of platelet-rich plasma（PRP） was used to measure RP%.The 20 patients in the group with critical platelet count were tested for RP% before and after glucocorticoid therapy.Results The groups with critical platelet count,heavily decreased platelet count and moderately decreased platelet count had the RP% values significantly higher than that of the control group（P〈0.05）,the groups with critical platelet count,heavily decreased platelet count and moderately decreased platelet count had the RP% values significantly higher than that of the group with lightly decreased platelet count（P〈0.05）,and there was no statistical difference between the RP% value of the group with lightly decreased platelet count and that of the control group（P〉0.05）.The 20 SLE patients in the group with critical platelet count had the RP% values before and after glucocorticoid therapy as（5.86±2.59）% and（3.14±1.97）% respectively,with statistical difference between them（P〈0.05）.Conclusion RP% may become a new indicator for assessing platelet activity in the patients with SLE,whose level is conducive to the diagnosis and prognosis of SLE by reflecting generation situations of bone marrow platelet.