6【检验与临床】【ClinicalLaboratoryTest】2010年2月第11卷第1期ChineseJournalofMedicalLaboratoryTechn01o．Feb2010．V01．11N0．1特发性血小板减少性紫癜血小板参数的临床意义CLINICALSIGNIFICANCEOFPLATELETANDCORRELATIVEPARAMETERSINIDIOPATHICTHROINBOCYTOPENICPURPURA李勇慕悦意李筱梅夏永辉张云霞田鹏杨佳或曹增(中国医学科学院北京协和医学院血液学研究所血液病医院，天津300020)摘要[目的]探讨特发性血小板减少性紫癜患者(idiopathicthrombocytopenicpurpura，ITP)血小板及其参数检测的临床意义以及与预后的相关性。[方法]应用SysmexXE一5000全自动五分类血液分析仪检测81例不同类型血小板减少症患者，包括40例再生障碍性贫血(aplasticanaemia，AA)和41例特发性血小板减少性紫癜(ITP)病人治疗前后血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、大血小板比率(P—LCR)和血小板分布宽度(PDW)，并将检测结果与正常对照组进行比较。[结果]初诊时ITP和AA患者的PIJ1、明显低于正常对照组(P<0．01)。(1)初诊时IrP患者PDW、MPV、P—LCR明显高于对照组和AA患者，差异均具有显著性(P<0．01)，而AA患者PDW、MPV、P—LCR低于对照组差异有统计学意义(P<0．01)；2、ITP患者缓解后PIJrr明显上升，而PDW、MPV、P—LCR下降；AA患者缓解后PIJT、PDW、MPV、P—LCR均上升。ITP和AA患者缓解组与未缓解组比较有统计学意义(P<0．01)。[结论]血小板参数的检测对于明确血小板减少的病因、病情判断及疗效观察其预后具有重要临床意义。关键词特发性血小板减少性紫癜；血小板参数ClinicalsignificanceofplateletandcorrelativeparametersinidiopathicthroinbocytopenicpurpuraYong，MuRu，LiXiaomei，eta1．InstituteofHematology，BloodDiseaseHospital，CAMSandPUMC，Tialfin300020，ChinaAbstract[objective]Toexploretheclinicalsignificanceofplateletandcorrelativeparametersinidiopathicthroinbocytopenicpur-pura．[Methods]Atotalof81patientswiththromhocytopeniawerestudied，including41caseswithidiopathicthrombocytopeniapurpura(ITP)and40patientswithaplasticanaemia(AA)．Theplateletindicesincludingplatelettotal(PLT)，meanplateletvolume(MPV)，plateletdistributionwidth(PDW)andplateletlargercellratio(P—LCR)weremeasuredbySysmexXE一5000automatedbloodcellana-lyzer．Theplateletindicesinthesepatientsbeforeandaftertreatmentwerefurtheranalyzedandstatisticallycomparedwiththoseofthecon—trois．[Results](1)Beforethetreatment，PIJTweresignificantlylowerinpatientswithITPandAAincomparisonwiththecontrolgroup(P<0．O1)．(1)MPV，PDWandP—LCRinpatientswithITPwereobviouslyincreasedthanthoseofthecontrolgroup(P<0．001)．Meanwhile，MPV．PDWandP—LCRinpatientswithAAwerereducedthanthoseofthecontrolgroup(P<0．001)．(2)Afterthetreat-ment，PLTwassignificantlyincreased，MPV，PDWandP—LCRwerereducedforcompleteremissiongroupofITPpatientsandPIJT，MPV．PDWandP—LCRwereincreased．InAAandITPpatients，thePTJTinducesofcompleteremissiongroupshoweddiferencetothoseofno—completeremissiongroup(P<0．001)．[Condusion]TheplateletindicescouldprovideimportantclinicalinformationabouttheunderlyingconditionsandprognosisofthrombocytopeniaKeywordsIdiopathicthrombocytopenicpurpura；Plateletindex[中图分类号]R558[文献标识码]B[文章编号]1606—8025(2010)01—006—03特发性血小板减少性紫癜(idiopathicthrombocytopenicpurpura，ITP)，其发病机制是由于免疫反应引起的血小板破坏增加，故又名自身免疫性血小板减少，是一类较为常见的出血性血液病。为了明确血小板减少的原因，临床上采用包括骨髓细胞学检查在内的多种检测方法，但这些检测方法存在有创性，结果易受干扰以及检测程序较为繁琐等缺陷。研究表明外周血血小板参数能反映骨髓中巨核细胞(MK)产生血小通信联系人，E—mail：caozengl@sina．con板的状态，...
