血小板减少性疾病病人血小板参数检测的临床意义

CLINICAL SIGNIFICANCE OF PLATELET PARAMETERS IN PATIENTS WITH THROMBOCYTOPENIA

目的探讨血小板减少性疾病病人血小板参数检测的临床意义。方法应用血细胞分析仪,检测94例原发免疫性血小板减少症(ITP)以及50例急性白血病(AL)、50例再生障碍性贫血(AA)、36例结缔组织病(CTD)导致的继发性血小板减少病人治疗前的血小板参数,包括血小板计数(PLT)、血小板压积(PCT)、血小板分布宽度(PDW)、血小板平均体积(MPV)、大血小板比率(P-LCR),以70例正常人作为对照组。结果与对照组比较,ITP组、AA组、AL组、CTD组P-LCR升高(F=79.53,P<0.05);ITP组、CTD组、AA组MPV升高(F=13.21,P<0.05);ITP组、AA组、AL组、CTD组PLT、PCT降低(F=821.55、670.66,P<0.05);AA组PDW降低(F=4.87,P<0.05)。与ITP组比较,AA组、AL组、CTD组PLT均升高,PDW、P-LCR均降低;AA组和CTD组PCT降低;AA组和AL组MPV降低(F=4.87~821.55,P<0.05)。与CTD组比较,AA组、AL组的MPV、PLCR以及AA组PCT均降低(P<0.05),AA组和AL组血小板参数差异无统计学意义(P>0.05)。ITP病人中完全反应组与部分反应组、无反应组比较,PLT、PCT显著升高,PDW、MPV、P-LCR显著降低,差异有统计学意义(F=6.10~64.90,P<0.05);与无反应组比较,部分反应组PLT升高,P-LCR降低,差异有统计学意义(P<0.05),PDW、MPV、PCT差异无显著性(P>0.05)。结论血小板参数检测有助于血小板减少性疾病的诊断及鉴别诊断,并且可用于评估ITP病人的预后。

Objective To investigate the clinical significance of platelet parameter measurement in patients with thrombocytopenia. Methods A blood cell analyzer was used to measure the platelet parameters in 94 patients with primary immune thrombocytopenia（ITP）,50 patients with acute leukemia（AL）,50 patients with aplastic anemia（AA）,36 patients with secondary thrombocytopenia caused by connective tissue disease（CTD）,and 70 normal persons（control group）before treatment,including platelet count（PLT）,plateletcrit（PCT）,platelet distribution width（PDW）,mean platelet volume（MPV）,and platelet large cell ratio（P-LCR）. Results Compared with the control group,the ITP group,the AA group,the AL group,and the CTD group had a significant increase in P-LCR（F=79.53,P〈0.05）;the ITP group,the CTD group,and the AA group had a significant increase in MPV（F=13.21,P〈0.05）;the ITP group,the AA group,the AL group,and the CTD group had significant reductions in PLT and PCT（F=821.55 and 670.66,P〈0.05）;the AA group had a significant reduction in PDW（F=4.87,P〈0.05）.Compared with the ITP group,the AA group,the AL group,and the CTD group had a signficant increase in PLT and significant reductions in PDW and P-LCR;the AA group and the CTD group had a significant reduction in PCT;the AA group and the AL group had a significant reduction in MPV（F=4.87-821.55,P〈0.05）.Compared with the CTD group,the AA group and the AL group had significant reductions in MPV and P-LCR（P〈0.05）,and the AA group had a significant reduction in PCT（P〈0.05）.There were no significant differences in platelet parameters between the AA group and the AL group（P〉0.05）.The ITP patients who achieved complete response had significant increases in PLT and PCT and significant reductions in PDW,MPV,and P-LCR,as compared with those who achieved partial response or had no response（F=6.10-64.90,P〈0.05）;compared with those who had no response,the ITP patients who achieved partial response had a significant increase in PLT and a significant reduction in P-LCR（P〈0.05）,while there were no significant differences in PDW,MPV,and PCT（P〉0.05）. Conclusion The measurement of platelet parameters helps with the diagnosis and differential diagnosis of thrombocytopenia and can be used to evaluate the prognosis of ITP patients.