血小板减少患者治疗前后血小板参数的变化及临床意义

目的探讨血小板减少患者治疗前后血小板参数的变化,为临床诊治提供指导意义。方法选取三类血小板减少患者102例,其中特发性血小板减少性紫癜(ITP)47例,再生障碍性贫血(AA)29例,急性白血病(AL)26例,采用SysmexXS-1000i全自动五分类血液分析仪检测血小板(PLT)及相关参数血小板比积(PCT)、血小板平均体积(MPV)、血小板分布宽度(PDW)、大血小板比率(P-LCR),并与健康对照及治疗前后对比。结果初诊时ITP的PLT、PCT明显低于对照组(P0.05)MPV、PDW、P-LCR明显高于对照组(P0.05)。AA、AL组患者的PLT、PCT、MPV明显低于对照组(P0.05),AA组PDW高于对照组。AL、AA与ITP比较,PLT,PCT差异无统计学意义(P0.05),MPV、PDW、P-LCR明显低于ITP组(P0.05)。治疗后缓解组ITP、AA、AL的PLT、PCT明显升高(P0.05),ITP组MPV、PDW、P-LCR明显下降。AA、AL组MPV、P-LCR明显升高(P0.05)。结论血小板参数的检测对于血小板减少的鉴别诊断与预后判断具有重要的临床意义。

Change and its clinical significance of pre- and post-treatment platelet parameters in thrombocytopenia

Objective To investigate the change and its clinical significance of pre-and post-treatment platelet parameters in thrombocytopenia to provide the guidance of clinical treatment.Methods A total of 102 patients with thrombocytopenia were studied,including 47 cases of idiopathic thrombocytopenia purpura（ITP）,26 cases of aplastic anemia（AA） and 29 cases of acute leukemia（AL）.The platelet total （PLT）,plateletocrit （PCT）,mean platelet volume（MPV）,platelet distribution width （PDW） and platelet-large cell ratio（P-LCR） were detected before and after treatment by Sysmex XS-1000i automated blood cell analyzer.The detection results before and after treatment were compared and statistically analyzed with healthy controls.Results PLT and PCT before treatment in ITP group were significantly lower than that of healthy controls,while MPV,PDW and P-LCR were significantly higher compared with the control.In particular,PLT,PCT and MPV in AA and AL groups were significantly lower compared with the control group（P0.05）.Additionally,PDW was significantly raised in AA group（P0.05）.There was no significant difference in PLT,PCT values among ITP,AA and AL,but MPV,PDW and P-LCR in AA and AL groups were lower than those in ITP group.Furthermore,PLT and PCT were elevated in remission or clinical improvement of ITP,AA and AL.Meanwhile,MPV,PDW and P-LCR were markedly decreased in remission or clinical improvement of ITP.However,MPV and P-LCR were obviously elevated in remission of AA and AL.Conclusion The platelet parameters could provide the important clinical information about differential diagnosis and prognosis of thrombocytopenia.