血小板相关参数在血小板减少性疾病诊断中的临床意义

目的 探讨血小板参数在血小板减少症诊治中的作用.方法 应用sysmex XE-5000自动化分析仪测定137例血小板减少患者特发性血小板减少性紫癜（ITP）34例,再生障碍性贫血（AA）18例,骨髓增生异常综合征（MDS）11例,慢性乙型肝炎36例,肝硬化33例,肝移植术后5例]和60例正常对照组的血小板计数（PLT）、血小板平均体积（MPV）、血小板分布宽度（PDW）、大血小板比率（P-LCR）及网织血小板百分比（IPF%）,并对临床资料进行分析.结果 6组患者外周血PLT绝对值均显著低于正常对照（P〈0.01）.ITP、MDS、肝硬化和肝移植患者外周血中IPF%明显高于正常对照（P〈0.05）,其中ITP组和肝移植组显著高于对照（P〈0.01）.ITP、肝硬化和肝移植患者MPV明显高于正常对照（P〈0.05）.ITP、慢性乙型肝炎、肝硬化和肝移植患者P-LCR明显高于正常对照（P〈0.05）,其中肝移植患者显著高于对照（P〈0.01）.ITP、慢性乙型肝炎、肝硬化和肝移植患者PDW明显高于正常对照（P〈0.05）,其中ITP和肝硬化患者显著高于对照（P〈0.01）.AA患者IPF%明显低于对照组（P〈0.05）,而MPV、P-LCR和PDW虽低于正常对照,但无统计学意义（P〉0.05）.结论 IPF%、MPV、PDW、P-LCR 检测的结果对血小板减少性疾病的病因诊断和治疗观察上有一定的参考价值.

Study on clinical significance of platelet-relevant parameters in diagnosis of thrombocytopenia.

Objective To explore the clinical significance of platelet relevant parameters in diagnosis of thrombocytopenia. Methods Platelet relevant parameters including platelet count （PLT） , mean platelet volume （MPV）, platelet distribution width （PDW）, ratio of platelet larger cells （ P LCR） and immature platelet fraction （ IPF% ） of 137 patients with thrombocytopenia 34 patients with idiopathic thrombocytope nie purpura（ITP） , 18 patients with aplastie anemia （AA） , 11 patients with myelodysplasia syndrome （MDS） , 36 patients with chronic hepatitis B, 33 patients with liver cirrhosis ,5 patients with liver transplantation and 60 normal controls were measured by automatic blood cell analyzer Sys mex XE 5000. Then all these results were analyzed and compared with clinical data. Results Platelet count in six groups was significantly lower than that of control group （ P 〈0.01 ）. IPF% in peripheral blood was obviously higher in patients with ITP, MDS, liver cirrhosis and liver trans plantation in comparison with that of control group（ P 〈 0.05 ）. IPF% in patients with ITP and liver transplantation was significantly higher （ P 〈 0. 01 ）. Additionally, MPV was obviously higher in patients with ITP, liver cirrhosis and liver transplantation compared with that of control group （ P 〈 0.05 ）. P LCR was obviously higher in patients with ITP, chronic hepatitis B, Liver cirrhosis and liver transplantation compared with that of control group （ P 〈 0.05 ） , especially in patients of liver transplantation （ P 〈 0.01 ）. PDW in patients with ITP, chronic hepatitis B, liver cir rhosis and liver transplantation was obviously higher than that of normal control group（ P 〈 0.05 ）, and it in ITP and liver transplantation groups was significantly higher （ P 〈 0.01 ）. Furthermore, IPF% of aplastic anemia group was obviously lower than that of normal controls （ P 〈 0.05 ）, so did MPV, P LCR and PDW in patients with aplastic anemia, but their difference had no statistical significance（ P 〉 0.05 ）. Conclusion The results of IPF%, MPV, PDW and P - LCR have certain referential value in diagnosis and clinical treatment of patients with thrombocytopenia.