特发性血小板减少性紫癜实验室特点与临床意义  

Clinical significance and laboratory behaviors in peripheral blood in children with Idiopathic Thrombocytopenic Purpura

作　　者：邱慧英[1] 柴忆欢[1] 季正华[1] 

机构地区：[1]苏州大学附属儿童医院血液科

出　　处：《中国小儿血液》2005年第1期21-23,共3页China Child Blood

摘　　要：目的 研究特发性血小板减少性紫癜实验特点与临床诊断、治疗效果的关系。方法对57例ITP患儿和15例健康儿童进行血小板计数(BPC)、平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板压积(PCT)测定;对57例ITP患儿用酶联免疫法(ELISA)检测血小板相关抗体(PAIgG、PAIgM);用聚合酶链反应(PCR)检测VB19、EBV、CMV;42例患儿接受地塞米松联合丙种球蛋白治疗。结果①治疗前,ITP组的BPC、PCT明显降低,与对照组比较有统计学意义(P<0.05),急性ITP(AITP)的PDW、MPV明显增加(P<0.05),慢性ITP(CITP)组PDW、MPV无明显变化(P>0.05)。②治疗后,AITP组PDW、MPV与对照组比较无明显变化(P>0.05);CITP组BPC、PCT仍明显减少,MPV呈明显增大(P<0.05),PDW呈分布宽度差异性变大。③丙种球蛋白治疗效果与血小板相关抗体(PAIgG、PAIgM)的表达有统计学意(X2值分别为5.03、3.96,P<0.05)。结论 血小板参数可作为ITP的诊断、病情严重程度的判别指标;血小板相关抗体PAIgG和PAIgM的表达对于指导丙种球蛋白临床治疗有一定的意义。Objective To study the relationship between the laboratory behaviors and clinical diagnosis as well as therapy of idiopathic thropbocytopenic purpura. Methods To use hemocyte autoanalyser to detect the parameters for platelet (BPC,PCT,MPV,PDW) in peripheral blood. Platelet-associated immunoglobulin by ELISA and VB19、CMV and EBV were detected by PCR, analyzed the results. 42 patients received MG and DEX. Results ①Pre - therapy: the levels of BPC,PCT were both decreased in AITP and CITP, and there was significant difference between ITP and the control group. The levels of PDW and MPV in AITP were increased compared with controls, while the levels of PDW and MPV were no difference between the CITP and the control. ②Post - treatment: The levels of BPC,PCT,MPV were still markedly different in CITP compared with the control. There were no difference in the levels of MPV, PDW in AITP compared with the control. ③ There was markedly difference in the effect of IVIG between patients with negative and positive Platelet - associated immunoglobulin. Conclusions The parameters for platelet may be useful indexs for diagnosing and telling the degrees of the states of the patients with Idiopathic Thrombocytopenic purpura. Platelet-associated immunoglobulin(PAIgG, PAIgM) maybe an useful index on treatment.

关 键 词：PDW ITP PAI 血小板相关抗体 特发性血小板减少性紫癜 丙种球蛋白 PCT 特点 结论 实验室 

分 类 号：R725.5[医药卫生—儿科]