特发性血小板减少性紫癜合并急性心肌梗死患者血小板参数变化的临床意义

目的:探讨特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)合并急性心肌梗死(acute myocardial infarction,AMI)患者治疗前后血小板参数临床意义。方法:选取ITP合并AMI的患者11例(ITP&AMI组);经冠脉造影检查确诊为AMI,排除血液系统疾病的患者30例(AMI组);临床诊断为ITP的患者30例(ITP组);健康者40例作为对照组。利用全自动血细胞五分类分析仪检测上述患者入院时及治疗后血小板的5项参数[血小板平均体积(mean platelet volume,MPV)、血小板平均分布宽度(platelet distribution width,PDW)、大血小板比率(platelet-large cell ratio,P-LCR)、血小板计数(platelet count,PLT)及未成熟血小板比率(immature platelet fraction,IPF)],对比研究各组间患者治疗前后血小板参数变化。结果:治疗前,ITP&AMI组与AMI组比较,MPV、PDW、P-LCR、PLT差异有统计学意义,IPF差异无统计学意义(P>0.05);ITP&AMI组与ITP组比较,PDW、IPF、P-LCR差异有统计学意义(P<0.05),PLT、MPV无统计学差异;AMI组与ITP组比较,MPV、PDW、P-LCR、PLT差异有统计学意义,IPF差异不明显;ITP&AMI组及ITP组与健康对照组比较MPV、PDW、P-LCR、PLT、IPF差异明显;AMI组与健康对照组比较MPV、PDW、PLT、IPF差异有统计学意义(P<0.01),而P-LCR差异无统计学意义。ITP&AMI组治疗后PDW、P-LCR、PLT、IPF与治疗前比较差异有统计学意义(P<0.01),两组间MPV比较差异无统计学意义(P>0.05);ITP&AMI组治疗前后PDW、P-LCR、PLT、IPF差异有统计学意义(P<0.01),MPV差异无统计学意义。ITP组及AMI组治疗前后MPV、PDW、P-LCR、PLT、IPF差异有统计学意义。结论:血小板参数有助于ITP合并AMI患者的病情诊断、疗效观察及对预后的预测。

The variations and clinical significance of platelet parameters in idiopathic thrombocytopenic purpura patients accompanied with acute myocardial in-farction

Objective:To investigate the variation of platelet parameters and its clinical significance in idiopathic thrombocyto-penic purpura patients and acute myocardial infarction ( AMI) before and after the occurrence of AMI. Methods:11 cases of patients with idiopathic thrombocytopenic purpura patients and acute myocardial infarction( ITP&AMI) ,30 cases of patients with acute myocar-dial infarction were diagnosed by CAG (AMI),30 cases of patients with idiopathic thrombocytopenic purpura (ITP),40 healthy people were included as control subject. Before and after treatment, 5 platelet parameters [ platelet count ( PLT ) , mean platelet volume ( MPV) ,platelet distribution width ( PDW) and platelet-large cell ratio ( P-LCR) and immature platelet fraction ( IPF) were detected in all cases;meanwhile,the detection results before and after treatment were compared and statistically analyzed with healthy controls. Results:Before treatment,MPV,PDW,P-LCR and PLT were statistically significant in ITP&AMI group and AMI group,IPF has no statistical significance(P>0. 05);P-LCR,PDW and IPF was statistically significant (P<0. 05) in ITP&AMI group and ITP group,PLT and MPV have no statistical significance(P>0. 05);MPV,PDW,P-LCR and PLT were statistically significant in ITP group and AMI group,IPF have no statistical significance;MPV,PDW,P-LCR,PLT and IPF were statistically significant in ITP&AMI group and ITP group control with the control;MPV,PDW,PLT and IPF were statistically significant(P<0. 01)in AMI group and the control,P-LCR has no statistical significance. PLT, P-LCR,PDW and IPF in ITP&AMI group of after treatment were statistically significant with the before (P<0. 01),there was no significant difference in MPV(P>0. 05);MPV,PDW,P-LCR,PLT and IPF in ITP group and AMI group of after treatment were statistically significant with the before. Conclusion:The platelet parameters could provide the important clinical information about treatment and prognosis of idiopathic thrombocytopenic purpura patients with acute myocardial infarction.