骨髓细胞学与网织血小板对肝硬化脾切除术后血小板的恢复预测  

Prediction of platelet recovery by bone marrow cytology and reticulocyte platelet in cirrhosis patients after splenectomy

作　　者：李妍[1] 杨宁[1] 王晗[1] 洪炜[1] 朱建功[1] 曲芬[1] 

机构地区：[1]解放军302医院临床检验医学中心,北京100039

出　　处：《中国卫生检验杂志》2014年第24期3554-3555,3558,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨骨髓细胞学分析及网织血小板(RP)检测在肝炎肝硬化患者脾切除术后PLT的恢复预测。方法选择92例明确诊断为肝炎肝硬化且临床表现为PLT减低而行脾切除术患者,进行骨髓细胞学分析、RP计数及其与PLT恢复的相关性。结果 1PLT计数与RP呈负相关,随着患者PLT计数的减低,RP增加越明显,骨髓巨核细胞成熟障碍越明显,有12.5%患者骨髓巨核细胞增生不良;2脾切除术后有3.2%患者PLT未恢复,骨髓巨核细胞均增生不良且外周血RP正常或减低。结论 PLT减少的肝炎肝硬化患者脾切除术后PLT的恢复与骨髓巨核细胞生成及RP有相关性,术前骨髓细胞学分析及RP检测可以在一定程度上预测脾切除术后PLT的恢复状况。Objective To evaluate the recovery of platelet（ PLT） by bone marrow cytology analysis and reticulocyte platelets（ RP） detection in thrombocytopenia after splenectomy in cirrhosis patients with viral hepatitis. Methods Total 92 cases of diagnosed hepatitis cirrhosis patients who accepted splenectomy for thrombocytopenia were selected,the analysis results of bone marrow cytology and RP count were conducted. The relationship between the detection results and platelet recovery was analyzed. Results 1PLT count was negative correlated with the RP,with the PLT count reducing in patients,the RP increasing was more obvious. Moreover,the megakaryocyte maturation in bone marrow was obstruction and 12. 5% megakaryocyte of bone marrow was hyperplasia in observed patients. 2The platelet of 3. 2% patients after splenectomy did not recovery,which accompanied by megakaryocyte dysplasia of bone marrow hyperplasia and normal or reduced reticulocyte platelet in peripheral blood.Conclusion The platelet recovery in hepatitis cirrhosis patients accepting splenectomy for thrombocytopenia was associated with the production of bone marrow megakaryocyte and reticulocyte platelets. The bone marrow cytology and reticulocyte platelet detection in cirrhosis patients after splenectomy can predict the platelet recovery.

关 键 词：肝炎肝硬化 脾切除 血小板减少 骨髓细胞学 网织血小板 

分 类 号：R575.2[医药卫生—消化系统]