特发性血小板减少性紫癜患者血小板生成素及网织血小板的检测意义

目的探讨检测血小板生成素（TPO）浓度及网织血小板（RP）百分率在特发性血小板减少性紫癜（ITP）发病机制中的作用。方法选取我院50例ITP患者（ITP组）和30例体检正常者（对照组）的临床资料，应用夹心酶联免疫吸附试验测定2组TPO浓度；流式细胞术检测2组RP百分率。采用全自动血细胞分析仪检测外周血血小板计数；采用常规细胞染色显微镜下直接计数法检测骨髓巨核细胞数。结果ITP组和对照组的血小板计数分别为（30．65±18．34）×10^9／L和（222．60±45．32）×10^0／L，RP百分率分别为（28．11±14．08）％和（8．19±2．46）％，巨核细胞数分别为（132．58±73．95）个／4cm2和（20．10±7．64）个／4m2，2组间血小板计数、RP百分率、巨核细胞数比较差异均有统计学意义（均P〈0．05），TPO浓度分别为（76．65±32．50）ng／L和（75．36±26．32）ng／L，2组比较差异无统计学意义（P〉0．05）。结论TPO浓度和RP百分率对提高ITP诊断水平及指导临床有一定的意义，可作为血小板减少性疾病鉴别诊断的有用指标。同时ITP患者TPO浓度的检测对于针对性应用促进血小板生成的TPO模拟物的治疗提供理论依据。

The significance of detection of thrombopoietin and reticulated platelet in the patients with idiopathic thrombocytopenic purpura

Objective To investigate the roles of thrombopoietin level and reticulated platelet percentage in the pathogenesis of idiopathic thrombocytopenic purpura. Methods The level of thrombopoietin and the percentage of reticulated platelet in 50 ITP patients and 30 healthy controls were tested by virtue of sandwich enzyme-linked immunosorbent assay and flow cytometry respectively. The peripheral platelet count was conducted with on automatic hemocyte analyzer. Meanwhile, the bone marraw megakargocget, using general staining method, was counted directly under microscope. Results Compared with the control group, the counts of platelets in ITP patients significantly decreased (P <0. 05) (30.65±18.34)×109/L and (222.60±45.32)×109/L; the percentage of reticulated platelet(28.11±14.08)% and 8. 19±2.46)% and megakaryocyte (132.58±73.95)/4 cm2 and (20. 10±7.64)/4 cm2 in ITP patients notablely increased (P < 0.05). However there was no apparent difference of the level of thrombopoietin between ITP patients and control group (76.65±32. 50) ng/L and (75.36±26. 32) ng/L (P>0.05).Conclusion Detecting the level of thrombopoietin in associated with the percentage of reticulated platelet in the patients with idiopathic thrombocytopenic purpura helps improve the diagnosis and clinical therapy of idiopathic thrombocytopenic purpura.