Sysmex XN血液分析仪未成熟血小板比率在血小板减少性疾病中的应用

Immature platelet fraction determination by Sysmex XN automated hematology analyzer for thrombocytopenia

目的评估Sysmex XN血液分析仪未成熟血小板比率(IPF%)在血小板减少性疾病中的应用。方法选取血小板减少性疾病患者200例[原发免疫性血小板减少症(ITP组)患者45例、再生障碍性贫血(AA组)患者40例、化疗患者(CT组)60例、慢性肝病(CLD组)患者55例]以及体检健康者(健康对照组)50名,采用Sysmex XN血液分析仪检测其外周血血小板(PLT)及IPF%,用Graph Pad Prism 6软件比较各疾病组与健康对照组之间IPF%差异,采用受试者工作特征(ROC)曲线分析IPF%在各组疾病中的诊断价值。结果 ITP组、AA组、CT组及CLD组PLT计数均显著低于健康对照组(P<0.05),而ITP组与AA组间以及CT组与CLD组间PLT计数差异无统计学意义(P>0.05)。ITP组IPF%显著高于健康对照组、AA组、CT组及CLD组(P<0.05),而AA组、CT组、CLD组及健康对照组之间IPF%差异均无统计学意义(P>0.05)。当IPF%临界值为5.8%时,其鉴别诊断ITP与低增生性PLT减少症的敏感性和特异性分别为82.2%和86.8%,曲线下面积(AUC)为0.92。结论 Sysmex XN血液分析仪IPF%参数在鉴别高增生性及低增生性PLT减少症中有一定应用价值。

Objective To evaluate the role of immature platelet fraction(IPF%)determination by Sysmex XN automated hematology analyzer for thrombocytopenia.Methods The platelet(PLT)counts and IPF% of 200 patients with thrombocytopenia [45 patients with primary immune thrombocytopenia(ITP),40 patients with aplastic anemia(AA),60 patients undergoing chemotherapy(CT)and 55 patients with chronic liver diseases(CLD)] and 50 healthy subjects(healthy control group)were determined by Sysmex XN automated hematology analyzer.The difference of IPF% was analyzed by GraphPad Prism 6 software,and receiver operating characteristic(ROC)curve analysis was utilized to demonstrate the diagnostic efficiency of IPF% in the assessment of thrombocytopenia.Results The PLT counts of ITP,AA,CT and CLD groups were lower than that of healthy control group(P<0.05).However,there was no statistical significance between ITP and AA groups and between CT and CLD groups(P >0.05).IPF% of ITP group was higher than those of healthy control,AA,CT and CLD groups(P<0.05),while there was no statistical significance between AA,CT and CLD groups and healthy control group(P >0.05).When the cut-off value of IPF% was 5.8%,the sensitivity was 82.2%,the specificity was 86.8%,and the area under curve(AUC)was 0.92.Conclusions IPF% determination by Sysmex XN automated hematology analyzer plays a role for discriminating hypo-from hyper-proliferative thrombocytopenias.