血小板参数在急性淋巴细胞白血病患者治疗前后的变化及临床意义

目的探讨急性淋巴细胞白血病(ALL)患者治疗前后血小板计数(PLT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)的变化及临床意义。方法应用NE-1500自动血细胞分析仪测定56例ALL患者治疗前和治疗后骨髓抑制期、骨髓恢复早期、完全缓解期的PLT、MPV、PDW,并以50例健康人的PLT、MPV、PDW作为对照。结果ALL患者的PLT、MPV比健康对照组降低(P0.01),而PDW差异无统计学意义(P0.05);在化疗后骨髓恢复早期,PLT、MPV、PDW比骨髓抑制期升高,差异有统计学意义(P0.01);在完全缓解期,PLT、MPV、PDW升高,与治疗前、抑制期、恢复早期相比,差异均有统计学意义(P0.01)。完全缓解组的PLT比治疗前和骨髓抑制期升高(P0.01),MPV、PDW比健康对照组升高(P0.01);未缓解组PLT比治疗前下降(P0.01),MPV、PDW与治疗前相比差异无统计学意义(P0.05)。结论PLT、MPV、PDW的变化在ALL治疗过程中具有一定的临床意义,是治疗后效果观察、预后判断的预示性指标。

The clinical significance of the changes of PLT,MPV,PDW in the patients with ALL during chemotherapy

Objective To study the changes and clinical significance of PLT,MPV,PDW in patients with ALL during chemotherapy. Methods NE-1500 automated blood cell analyzer was used to test the PLT,MPV,and PDW in 56 cases of patients with ALL before and after chemotherapy,and the test results were compared with the one of the 50 cases of health controls. Results The PLT and MPV were significantly lower in the patients with ALL than those in the controls before chemotherapy（P〈0. 01） ,but there was no difference in comparlsion with PDW（P〈0.05）; In the early stage of marrow remission,the results of PLT,MPV,and PDW were remarkbally higher than those in the marrow restrain（P〈0.01 ） ; Upon the complete remission, the results of PLT, MPV, and PDW were markedly higher than those at the onset stage, the marrow restrain stage and the marrow remission stage（P〈0.01）. The result of PLT was significantly higher in complete remission patients of ALL after chemotherapy（P〈0.01）. And the results of MCV and PDW were significantly higher than that in control group（P〈0.01 ）. The result of PI,T was significantly lower in non remission patients after chemotherapy, while MPV and PDW have no significant difference（P〈 0.05）. Conclusion It showsl that it is of an important value to study the changes of PLT,MPV and PDW in patients with ALL for cherishing the function of bone marrow,the treatment and prognosis during chemotherapy.