121例妊娠相关性血小板减少症的血小板参数检测临床意义

Clinical Significance of Platelet Parameter Detection for 121 Pregnancy-related Thrombocytopenia

目的:探讨检测血小板参数对妊娠相关性血小板减少症(PAT)的临床价值。方法:将我院2015年12月-2018年12月收治的121例妊娠相关性血小板减少症患者作为实验组,同时选取同期正常妊娠的50例及免疫性血小板减少症(ITP)合并妊娠28例作为对照组,检测三组患者外周血液标本血小板参数,评估其临床意义。结果:实验组(PAT组)与正常妊娠对照组相比,PAT组PLT明显下降(P<0.05),而血小板体积(PCT)、血小板体积分布宽度(PDW)以及平均血小板体积(MPV)与对照组相比无明显变化(P>0.05);但与ITP对照组相比,ITP对照PDW及MPV水平明显上升,PCT与PLT水平显著下降(P<0.05)。PAT组轻度血小板减少占66.9%,显著高于ITP对照组(P<0.05),而PAT组重度血小板减少显著低于ITP对照组(P<0.05)。PAT组患者产后血小板恢复正常时间在1周内者分别占82.64%,明显高于ITP组,而ITP对照组产妇产后血小板复常时间有92.86%均超过4周,明显长于PAT组(P<0.05)。结论:检测血小板参数及动态监测其变化对于诊断及鉴别诊断妊娠相关性血小板减少症(PAT)有重要临床价值,值得临床重视及推广使用。

Objective:To investigate the clinical value of detecting platelet parameters in pregnancy-related thrombocytopenia(PAT). Methods:121 patients with pregnancy-related thrombocytopenia admitted to our hospital from December 2015 to December 2018 were enrolled as the experimental group. 50 patients with normal pregnancy and 28 patients with immune thrombocytopenia(ITP)and pregnancy were selected. As a control group,platelet parameters of peripheral blood samples were measured in three groups of patients,and their clinical significance was evaluated. Results:In the experimental group(PAT group),compared with the normal pregnancy control group,the PLT of the PAT group decreased significantly(P<0.05),and the platelet volume(PCT),platelet volume distribution width(PDW)and The mean platelet volume(MPV)had no significant change compared with the control group,and the difference was not statistically significant(P>0.05). However,compared with the ITP control group,the ITP control PDW and MPV levels increased significantly,and the PCT and PLT levels decreased significantly(P<0.05). The mild thrombocytopenia in the PAT group was 66.9%,which was significantly higher than that in the ITP control group(P<0.05),while the severe thrombocytopenia in the PAT group was significantly lower than that in the ITP control group(P<0.05). The normal time of postpartum platelet recovery in the PAT group was 82.64% in 1 week,which was significantly higher than that in the ITP group. The postpartum platelet recurrence time of the ITP control group was 92.86%,which was more than 4 weeks,which was significantly longer than the PAT group(P<0.05). Conclusion:The detection of platelet parameters and dynamic monitoring of its changes have important clinical value for the diagnosis and differential diagnosis of pregnancy-related thrombocytopenia(PAT),which deserves clinical attention and promotion.