巨核细胞与血小板参数在血小板减少性疾病中的应用

目的探讨巨核细胞与血小板(PLT)参数在血小板减少性疾病中的应用价值。方法对72例血小板减少症患者分组进行巨核细胞数及血小板4项参数[PLT、血小板体积(PCT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)]检测,并做比较。结果与正常对照组相比,PLT值特发性血小板减少性紫癫(ITP)组最低(P<0.01),脾亢组次之(P<0.01),PCT与PLT变化一致,各组PDW均增高(P<0.01),MPV以ITP组与免疫组显著增高(P<0.05);其他各组与ITP组相比,巨核细胞数、PLT值、PCT均有显著性差异(P<0.01),免疫组与ITP组相比MPV、PDW有显著性差异(P<0.05)。4组病例骨髓均表现为巨核细胞成熟障碍,ITP组巨核细胞总数及颗粒巨明显增多,巨幼细胞性贫血(MgA)组巨核细胞呈病态改变。结论观察血小板参数及巨核细胞的形态特征,对血小板减少性疾病诊断及鉴别诊断具有重要意义。

Study on significance of examination of number of megakaryocytes and platelet parameters in thrombocytopenic diseases

Objective To explore the significance of examination of number of megakaryocytes and platelet parameters in treatment of thrombocytopenic diseases.Methods The changes in number of megakaryocytes and four parameters of platelets[platelets（PLT） count,platelet volume（PCT）,mean platelet volume（MPV）,platelet distribution width（PDW） ]were examined and compared in 72 cases of thrombocytopenia.Results In comparison with normal control group,the PLT count in patients of ITP group was the lowest（P 〈 0.01）,and patients with hypersplenism group arranged at the next（P 〈 0.01）.Changes in PCT were consistent with the number of PLT count,and MPV in patients of ITP group and immunogenic group was significantly increased（P 〈 0.05）.There was significant difference in number of megakaryocyte count,PLT count and PCT in ITP group compared with other groups（P 〈 0.01）.There was significant difference in values of MCV and PDW between immunogenic group and ITP group（P 〈 0.05）.The bone marrow examination in patients of four groups demonstrated retard in maturation of megakaryocytes.The total number of megakaryocytes and granular megakaryocytes was significantly increased in patients with ITP group,and pathological changes in megakaryocytes were seen in patients with MgA group.Conclusion The observation on platelet parameters and morphologic features of megakaryocytes has important significance in diagnosis and differential diagnosis of thrombocytopenic disorders.