网织红细胞参数在乳腺癌患者放疗过程中的变化  

Clinical Research of Reticulocyte Parameters in Breast Cancer Radiotherapy Process

作　　者：刘志贤[1] 李剑鸿[1] 李星[1] 袁雯[1] 

机构地区：[1]湘潭市第一人民医院检验科,湖南湘潭411101

出　　处：《医学综述》2012年第18期3077-3079,共3页Medical Recapitulate

基　　金：湖南省湘潭市科学自然基金(ZJ103005)

摘　　要：目的了解乳腺癌患者放疗导致骨髓造血功能抑制和恢复过程中白细胞(WBC)、血小板(PLT)、网织红细胞百分率(RET%)、高荧光强度网织红细胞百分率(HFR%)、中荧光强度网织红细胞百分率(MFR%)的动态变化情况。方法选择乳腺癌患者68例为放疗组,选择健康体检者36例为对照组,采用Sysmex全自动血细胞分析仪XT-2000i检测放疗前和放疗后第7、14、21、28、35、42天外周血WBC、PLT、RET%、HFR%、MFR%,对照组与放疗前比较及放疗组放疗前后各项指标的变化。结果放疗前组网织红细胞参数与正常对照组的RET%和HFR%比较,与放疗前的差异有统计学意义(P<0.05)。放疗组放疗前后组网织红细胞参数比较差异均有统计学意义(P<0.05),第7天,WBC、RET%、HFR%和MFR%已开始下降,差异有统计学意义(P<0.05);第14、21、28天,WBC、PLT、RET%、HFR%和MFR%持续下降,显著低于放疗前,差异有统计学意义(P<0.05);第35天,WBC和PLT持续低于放疗前,差异有统计学意义(P<0.05);第42天,WBC和PLT恢复到正常水平,低于放疗前水平,HFR%和MFR%持续增高,显著高于放疗前水平,差异有统计学意义(P<0.05)。结论 WBC、PLT、RET%、HFR%和MFR%5项参数可作为评价乳腺癌患者放疗后骨髓造血功能受抑和开始恢复的敏感指标,帮助临床医师及时调整治疗方案,不失时机地给予各种支持疗法及化疗时机的选择,具有重要的临床意义。Objective To explore the dynamic changes of white blood cell（WBC）,platelet（PLT）,reticulocyte（RET）%,high fluorescence intensity reticulocytes（HFR）% and medium fluorescence intensity reticulocytes（MFR）% which can reflect the bone marrow hematopoietic function suppression or recovery on the breast cancer radiotherapy process.Methods 68 breast cancer patients were selected as radiotherapy group,whose WBC,PLT,RET%,HFR%,MFR% data were collected using sysmex XT-2000i before and 7 days,14 days,21 days,28 days,35 days,42 days after radiotherapy.36 healthy people were selected as normal group.The indexes of the two groups were compared;the indexes of the radiotherapy group before and after treatment were compared.Results Compared with normal group,the RET%,HFR% of radiotherapy group before treatment were different（P〈0.05）.Compared with before radiotherapy,the reticulocyte parameters were different after treatment.On the 7th day,WBC,RET%,HFR% and MFR% were lower（P〈0.05）;On the 14th,21st and 28th day,the five parameters progressively reduced and were all lower than before radiotherapy（P〈0.05）.On the 35th day,WBC and PLT were still lower（P〈0.05）.On the 42nd day,WBC and PLT recovered to normal level but lower than before radiotherapy.HFR% and MFR% progressively increased and were significantly higher than before radiotherapy（P〈0.05）.Conclusion WBC,PLT,RET%,HFR%,MFR% are sensitive indexes and can be chosen to evaluate the bone marrow hematopoietic function suppression or recovery in breast cancer patients after radiotherapy,which can help doctors to adjust the treatment solution and choose correct supporting therapies and chemotherapy timely.

关 键 词：乳腺癌 放疗 网织红细胞参数 

分 类 号：R556[医药卫生—血液循环系统疾病]