儿童过敏性紫癜外周血血小板参数及D-二聚体水平变化  

Analysis of Peripheral Platelet Parameters and D-dimer in Children with Henoch-Schonlein Purpura

作　　者：孙燕[1] 张惠君[1] 常红[1] 张秋业[1] 陈玉秀[1] 

机构地区：[1]青岛大学医学院附属医院儿科,山东青岛266003

出　　处：《现代生物医学进展》2013年第11期2073-2077,共5页Progress in Modern Biomedicine

摘　　要：目的:探讨外周血血小板参数及D-二聚体水平在儿童过敏性紫癜(Henoch-Schonlein purpura,HSP)的变化及临床意义。方法:选择2010年6月至2012年5月间青岛大学医学院附属医院儿科住院过敏性紫癜患儿137例为研究对象,儿童保健科健康查体儿童50例为对照组。血小板参数包括血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板体积分布宽度(PDW),采用XE-2100全血细胞分析仪、电阻抗法检测;血浆D-二聚体采用胶乳比浊法检测。结果:与对照组比较,HSP患儿急性期外周血PLT、PCT显著升高(P<0.05),而MPV显著降低(P<0.05),PDW无显著差异(P>0.05);有无胃肠道出血HSP组间和有无肾脏受损HSP组间血小板参数并无显著性差异(p>0.05)。84例(61.3%)HSP患儿急性期血浆D-二聚体水平增高,其绝对浓度(中位数)为435 ng/ml,显著高于正常水平(0-300 ng/ml);不同HSP临床表型组间血D-二聚体异常率和绝对浓度均无显著性差异(X2=2.75,P>0.05;H=3.37,P>0.05);合并胃肠道出血组与无消化道出血组比较HSP病儿血浆D-二聚体水平显著升高(Z=-2.691,P<0.05);合并肾损害与无肾损害组比较HSP病儿血浆D-二聚体水平显著降低(Z=-4.063,P<0.05)。结论:HSP患儿急性期血液处于高凝及继发的纤溶状态,早期检测血小板参数及D-二聚体变化水平,指导临床诊断及临床用药。Objective： To investigate the levels and clinical significance of peripheral platelet parameters and d-dimer in children with Henoch-Sch？nlein purpura（HSP）.Methods： One hundred and thirty-seven patients diagnosed as HSP and fifty healthy children were enrolled.Platelet parameters,including platelet counts（PLT）,mean platelet volume（MPV）,platelet crit（PCT）,platelet distribution width（PDW） were measured by resistance method using XE-2100 automatic blood count device.Plasma d-dimer was measured by latex turbidity.Results： Compared with that in controls,PLT and PCT were significantly higher in acute period of HSP patients（p0.05）,while MPV was significantly lower（P〉0.05） and PDW had no significant difference（P〉0.05）.Platelet parameters were similar in patients with gastrointestinal（GI） bleeding than those without bleeding（P〉0.05）.Platelet parameters were similar in patients with renal damage than those without renal damage（P〉0.05）.Plasma d-dimer concentration of HSP patients in acute period（median=435 ng/ml） were higher than that in normal（0-300 ng/ml）.The abnormal rates and concentrations of plasma d-dimer had no significant difference among groups of HSP patients（X^2 =2.75,P〉0.05;H=3.37,P〉0.05）.D-dimer were significantly higher in patients with GI bleeding than those without bleeding（Z =-2.691,P〉0.05）.D-dimer was significantly lower in patients with renal damage than those without renal damage.Conclusions： Hypercoagulability and subsequent hyperfibrinolysis is a typical feature of acute period of HSP.So the levels of peripheral platelet parameters and d-dimer should be delected early to guide clinical diagnosis and clinical drug use.

关 键 词：D-二聚体 血小板参数 过敏性紫癜 儿童 

分 类 号：R725.5[医药卫生—儿科]