特发性血小板减少性紫癜病人外周血像及骨髓巨核细胞数与预后关系

为了探讨特发性血小板减少性紫癜 (ITP)病人初诊时血像及骨髓涂片巨核细胞计数的预后价值 ,作者回顾性分析了 2 2 9例ITP病人外周血白细胞计数、血小板计数、治疗过程中血小板上升速度及骨髓涂片巨核细胞计数与治疗结果之间的关系。结果显示 ,ITP病人初诊时外周血白细胞计数及血小板计数与疗效无关 ,治疗 2周内血小板达到 10 0× 10 9/L以上的病人 ,其基本治愈率较高 (94 .9% ) ;初诊时骨髓涂片巨核细胞计数越多 ,病人的预后越好 ,每单位涂片 (1.5× 3cm)巨核细胞计数大于 10 0个的病人治愈率达 86 .1%。结论 :ITP病人初诊时进行骨髓检查 ,并计数巨核细胞数 ,对诊断及预后的判定均是必要的。在治疗过程中及时复查血像 ,观察血小板上升速度 ,对预后的判定亦有重要价值

Prognostic Significance of Peripheral Blood Cell and Bone Marrow Megakaryocyte Counts in Patients with Idiopathic Thrombocytopenic Purpura

To clarify the prognostic contribution of peripheral blood cell and bone marrow megakaryocyte counts in patients with idiopathic thrombocytopenic purpura, a series of data of 299 ITP patients including the counts of peripheral white blood cells and platelets, their increase potentials after treatment and the megakaryocytic counts on the bone marrow smears at diagnosis as well were collected and retrospectively analyzed to correlate with the disease development. The results showed that peripheral white blood cell and platelet counts at diagnosis were not associated with the prognosis, but positively associated with the increment of platelet counts after treatment. The cure rate reached up to 94.9% in the group with the platelet level restored to 100 x 10(9)/L in two weeks of therapy. The numerous megakaryocyte counts in bone marrow at diagnosis indicated good prognosis that the cure rate was up to 86.1% when the counts were more than 100 per 1.5 x 3 cm of smear. In conclusion, bone marrow examination on the quantity and quality of megakaryocyte would be critical for diagnosis and evaluation of the prognosis. Consecutive platelet counts during therapy is useful to estimate the disease development.