中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2008年
5期
417-419
,共3页
饶沃明%王健%黄美筠%莫建坤%周小棉
饒沃明%王健%黃美筠%莫建坤%週小棉
요옥명%왕건%황미균%막건곤%주소면
血小板减少症%血小板参数%血小板平均体积%血小板分布宽度
血小闆減少癥%血小闆參數%血小闆平均體積%血小闆分佈寬度
혈소판감소증%혈소판삼수%혈소판평균체적%혈소판분포관도
Thrombocytopenia%Platelet size indices%Mean platelet volume%Platelet distribution width
目的 探讨血小板参数在鉴别骨髓性和非骨髓性血小板减少症中的作用.方法 使用Cell-Dyn3700血细胞分析仪检测血小板减少症(TP)76例、特发性(免疫性、原发性)血小板减少性紫癜(ITP)66例、继发性血小板减少性紫癜(STP)8例、获得性纯巨核细胞再生障碍性血小板减少性紫癜(AATP)8例、造血干细胞疾病(HSCD)(急性白血病、再生障碍性贫血、骨髓增生异常综合征)140例、健康体检者100例(对照组)的血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW).结果 ①与对照组相比,HSCD患者的MPV显著减少,PDW明显增加;STP患者MPV、PDW显著增大.②AATP患者MPV正常,PDW增大.③ITP组和TP组与对照组的MPV、PCT、PDW差异有统计学意义(均P＜0.01).④HSCD组与对照组、ITP组和TP组比较,MPV、PCT和PDW差异有统计学意义(均P＜0.01).⑤骨髓性TP组与非骨髓性TP组比较,其MPV和PDW均有统计学意义(均P＜0.01).⑥当ITP患者治疗有效时,PLT升高,其MPV和PDW下降.结论 通过观察MPV和PDW数值的升降,特别是MPV的变化可初步判断血小板减少是由骨髓病变(MPV＜参考值)还是由骨髓外病症(MPV＞参考值)所引起.另外,当ITP患者治疗有效时,可用PDW和MPV较早地(比PLT提前5 d)观察到疗效.血小板参数的动态观察有助于ITP的鉴别诊断、病情判断及疗效观察.
目的 探討血小闆參數在鑒彆骨髓性和非骨髓性血小闆減少癥中的作用.方法 使用Cell-Dyn3700血細胞分析儀檢測血小闆減少癥(TP)76例、特髮性(免疫性、原髮性)血小闆減少性紫癜(ITP)66例、繼髮性血小闆減少性紫癜(STP)8例、穫得性純巨覈細胞再生障礙性血小闆減少性紫癜(AATP)8例、造血榦細胞疾病(HSCD)(急性白血病、再生障礙性貧血、骨髓增生異常綜閤徵)140例、健康體檢者100例(對照組)的血小闆計數(PLT)、平均血小闆體積(MPV)、血小闆壓積(PCT)、血小闆分佈寬度(PDW).結果 ①與對照組相比,HSCD患者的MPV顯著減少,PDW明顯增加;STP患者MPV、PDW顯著增大.②AATP患者MPV正常,PDW增大.③ITP組和TP組與對照組的MPV、PCT、PDW差異有統計學意義(均P＜0.01).④HSCD組與對照組、ITP組和TP組比較,MPV、PCT和PDW差異有統計學意義(均P＜0.01).⑤骨髓性TP組與非骨髓性TP組比較,其MPV和PDW均有統計學意義(均P＜0.01).⑥噹ITP患者治療有效時,PLT升高,其MPV和PDW下降.結論 通過觀察MPV和PDW數值的升降,特彆是MPV的變化可初步判斷血小闆減少是由骨髓病變(MPV＜參攷值)還是由骨髓外病癥(MPV＞參攷值)所引起.另外,噹ITP患者治療有效時,可用PDW和MPV較早地(比PLT提前5 d)觀察到療效.血小闆參數的動態觀察有助于ITP的鑒彆診斷、病情判斷及療效觀察.
목적 탐토혈소판삼수재감별골수성화비골수성혈소판감소증중적작용.방법 사용Cell-Dyn3700혈세포분석의검측혈소판감소증(TP)76례、특발성(면역성、원발성)혈소판감소성자전(ITP)66례、계발성혈소판감소성자전(STP)8례、획득성순거핵세포재생장애성혈소판감소성자전(AATP)8례、조혈간세포질병(HSCD)(급성백혈병、재생장애성빈혈、골수증생이상종합정)140례、건강체검자100례(대조조)적혈소판계수(PLT)、평균혈소판체적(MPV)、혈소판압적(PCT)、혈소판분포관도(PDW).결과 ①여대조조상비,HSCD환자적MPV현저감소,PDW명현증가;STP환자MPV、PDW현저증대.②AATP환자MPV정상,PDW증대.③ITP조화TP조여대조조적MPV、PCT、PDW차이유통계학의의(균P＜0.01).④HSCD조여대조조、ITP조화TP조비교,MPV、PCT화PDW차이유통계학의의(균P＜0.01).⑤골수성TP조여비골수성TP조비교,기MPV화PDW균유통계학의의(균P＜0.01).⑥당ITP환자치료유효시,PLT승고,기MPV화PDW하강.결론 통과관찰MPV화PDW수치적승강,특별시MPV적변화가초보판단혈소판감소시유골수병변(MPV＜삼고치)환시유골수외병증(MPV＞삼고치)소인기.령외,당ITP환자치료유효시,가용PDW화MPV교조지(비PLT제전5 d)관찰도료효.혈소판삼수적동태관찰유조우ITP적감별진단、병정판단급료효관찰.
Objective To investigate the role of platelet indices in the differentiation of thrombocytopenia caused by bone marrow diseases and thrombocytopenia caused by non-marrow diseases.Methods Mean platelet volume(MPV),platelet crit(PCT)and platelet size deviation width(PDW)of 76 othromboeytopenia(TP)patients,66 immune thrombocytopenia purpura(ITP)patients,8 secondary thrombocytocritpenia purpura(STP)patients,8 acquired pure megakaryocytic thrombocytopenia purpura(AATP)patients,140 malignant hematological diseases(MHD)(including acute leukemia,aplastic anemia and myelodysplastic syndromes)patients and 100 healthy people were respectively determined by blood cell analyzer Cell-Dyn 3700.Result Compared with control group,the MPV of the patients with MHD significantly decreased,and then the PDW of them increased.For patients with STP,the MVP and PDW markedly increased.The MVP of patients with AATP was normal,and PDW significantly increased.The MPV,PCT and PDW of ITP and TP showed marked difference(P＜0.01).In contrast with the control group,the MPV,PCT and the PDW of patients with hemopathy and patients with ITP were remarkably different(P＜0.01).Compared with the marrow TP and the non-marrow TP or control group,MPV and PDW showed significant difference(P＜0.01).During the effective treatment of patients with ITP,PLT increased and then MPV and PDW decreased.Conclusion The level changes of MPV and PDW,in particular MPV can primarily judge the cause of thrombocytopenia (MPV＜reference value as caused by bone marrow diseases but MPV＞reference value as caused by bone marrow diseases).In addition,during the effective treatment of patients with ITP,with changes of MPV and PDW present 5 days earlier than that of PLT,may used to observe the therapeutic effect.Myelodysplastic syndromedynamic observation of the platelet parameter helps for the differential diagnosis,judgment of the states of the diseases and observation of the effectiveness of therapy of ITP.
