苯中毒性再生障碍性贫血患者外周血网织血小板水平观察

Observation on the levels of peripheral reticuloplatelets in aplastic anemia patients caused by benzene poisoning

目的 探讨苯中毒性再生障碍性贫血 (BPAA)患者外周血网织血小板 (RPs)的变化规律。方法 采用流式细胞仪技术测定 47例BPAA患者外周血RPs的比例和绝对值 ,观察RPs在BPAA中的变化规律 ,并与 3 0例健康对照组进行比较。结果 苯中毒性急性再生障碍性贫血 (ABPAA)患者外周血中RPs百分率及绝对计数均低于正常对照组(P <0 0 5 ) ;苯中毒性慢性再生障碍性贫血 (CBPAA)患者外周血中RPs百分率与正常对照组差异无显著性 (P >0 0 5 ) ,而RPs绝对计数低于正常对照组 ,差异有显著意义 (P <0 0 5 )。CBPAA和ABPAA组之间RPs百分率及绝对计数差异有显著性 (P <0 0 5 )。RPs绝对计数与BPC计数间呈正相关 (r =0 74)。治疗有效的患者在外周血象开始好转前 ,首先出现RPs %上升。 2 2例ABPAA患者按疗效分成治疗有效组和治疗无效组 ,治疗有效组患者的RPs %及RPs绝对计数均明显高于治疗无效组 ,差异有显著意义 (P <0 0 5 )。结论 在BPAA患者中 ,RPs %及RPs绝对计数的水平间接地反映了苯对骨髓的损害程度 。

Objective To study the change regularity of the peripheral reticuloplatelets (RPs) in the aplastic anemia patients caused by benzene poisoning (BPAA).Method The percentage and absolute count of RPs in peripheral blood were detected by flow cytometer in 47 BPAA patients and 30 normal controls.Result The patients with acute aplastic anemia (ABPAA) had much lower percentage and absolute count of RPs compared with controls and the patients with chronic aplastic anemia by benzene poisoning (CBPAA);there was no difference in percentage of RPs compared with the patients with CBPAA patients and the controls(P>0.05),but the absolute count of RPs in CBPAA patients was lower than that of controls(P<0.05).The absolute count of RPs had a positive correlation with BPC(r=0.74);before improvement of BPC of peripheral blood in the effective patients to treatment,the percentage of RPs already showed increased;there were significantly higher percentage and absolute counts of RPs in effective ABPAA patients than that of ineffective patients (P<0.05).Conclusion The percentage and absolute counts of RPs could indirectly reflect damage degree of bone marrow by benzene,and might be a helpful index for predicting the effect of therapy.