破碎红细胞计数在血栓性微血管病诊断和治疗中的意义

Significance of broken red blood cell count in diagnosis and treatment of thrombotic microangiopathy

目的探讨破碎红细胞计数在血栓性微血管病(TMA)诊断和治疗评估中的价值。方法回顾性分析2019年1月—2020年5月温州医科大学附属第一医院收治的100例TMA患者(包括原发性和继发性)和50例免疫性血小板减少性紫癜(ITP)患者的外周血破碎红细胞百分比以及血小板(PLT)数进行统计分析;连续检测并分析10例TMA患者治疗后血小板数的回升与破碎红细胞百分比,并进行相关分析。结果TMA患者外周血破碎红细胞计数百分比明显高于ITP患者(P<0.05)。随着TMA治疗后临床症状的改善,PLT数上升,破碎红细胞百分比呈下降趋势。引起TMA的主要诱因有SLE、感染、恶性肿瘤和高血压。结论外周血破碎红细胞计数可作为血栓性微血管病的一个较好的早期诊断指标及疗效评估指标,对患者进行早期诊断治疗有重要的意义。

Objective To explore the value of fragmented red blood cell count in the diagnosis and treatment of thrombotic microangiopathy(TMA).Methods From January 2019 to May 2020,100 patients with TMA(including primary and secondary TMA)and 50 patients with immune thrombocytopenic purpura(ITP)from the First Affiliated Hospital of Wenzhou Medical University were analyzed retrospectively.The percentage of peripheral blood fragmented red blood cells and the platelet count were statistically analyzed;The recovery of platelet count and the percentage of fragmented red blood cells in 10 TMA patients after treatment were continuously detected and analyzed.Results The percentage of fragmented red blood cells in peripheral blood of TMA patients was significantly higher than that of ITP patients(P<0.05).With the improvement of clinical symptoms after TMA treatment,the platelet increased and the percentage of fragmented red blood cells decreased.The main causes of TMA are SLE,infection,malignant tumor and hypertension.Conclusion The count of fragmented red blood cells in peripheral blood can be used as a better diagnostic index and curative effect evaluation index of thrombotic microangiopathy,which is of great significance for the diagnosis and treatment of patients.