血小板生成素对血小板减少性疾病鉴别诊断及疗效判断的应用价值  

The value of thrombopoietin(TPO)for differential diagnosis and treatment of thrombocytopenic Diseases

作　　者：文瑞婷 杨志刚[1] 龙杰[1] 吴国才[1] 梁亮[1] 

机构地区：[1]广东医学院附属医院血液内科,广东湛江524001

出　　处：《中国实验诊断学》2016年第6期955-958,共4页Chinese Journal of Laboratory Diagnosis

基　　金：广东省自然科学基金(No.S2011010005325);广东省科技计划基金项目(No.2014A020212300);广东医学院科研基金项目(No.M2014025);广东省医学科研基金项目(No.A2015547)

摘　　要：目的探讨血小板生成素(TPO)对血小板减少性疾病鉴别诊断及疗效判断的应用价值。方法采用夹心酶联免疫吸附法测定了117例血小板减少患者及35例健康对照者血清TPO水平并进行分组比较,血小板减少患者包括再生障碍性贫血(AA)44例(初治21例、治疗后23例)、骨髓增生异常综合征(MDS)14例、免疫性血小板减少症(ITP)37例(疗效明显组22例、疗效欠佳组15例)、急性白血病(AL)21例、未明确诊断1例。结果 1各组血清TPO水平的比较:AA组、MDS组、ITP组、AL组及正常对照组血清TPO水平分别为(1 964.47±734.74)pg/ml、(248.85±149.35)pg/ml、(316.43±206.67)pg/ml、(1 436.37±949.25)pg/ml和(316.01±164.21)pg/ml。AA组与AL组均明显高于正常对照组(P<0.05);MDS组、ITP组与正常对照组比较差异无显著性(P>0.05);AA组与AL组比较差异无显著性(P>0.05);MDS组与ITP组比较差异无显著性(P>0.05);AA组明显高于MDS组与ITP组(P<0.05);AL组明显高于MDS组与ITP组(P<0.05)。2皮质激素疗效明显组ITP患者初诊时血清TPO水平[(233.30±127.85)pg/ml]低于皮质激素疗效欠佳组[(447.06±241.90)pg/ml],P<0.05。3AA患者初治组血清TPO水平[(1 979.67±748.41)pg/ml]与治疗有效组[(1 954.55±742.44)pg/ml]比较无明显差异,P>0.05。结论检测血小板减少患者的血清TPO水平,有助于血小板减少性疾病的鉴别诊断;ITP患者初诊时血清TPO水平与皮质激素疗效相关。Objective To investigate the value of thrombopoietin（TPO） for differential diagnosis and treatment of thrombocytopenia. Methods Serumlevels of TPO in 35 normal persons and 117 patients of 44 with aplastic anemia （AA）, 14with myelodysplastic syndrome （MDS）, 37 with immune thrombocytopenia（ITP）, 21 with acute leukemia （AL）, 1 with uncertain diagnosis were measured with a sandwich-enzymelinked immunosorbent assay（ELISA） kit. Results （DThe serum level of TPO in AA,MDS,ITP,AL and controls was （1964.47±734. 74） pg/ml,（248.85±149.35） pg/ml, （316.43 ± 206.67） pg/ml, （1436. 37 ± 949. 25） pg/ml and （316.01±164.21） pg/ml respectively. Compared with controls, serum levels of TPO in AA and AL were elevated signifieantly（P〈0. 05）. Compared with controls ,There was no difference of serum TPO concentration in ITP and MDS（P〉0.05）. There was no difference between serum TPO concentration in AA and AL（P〉0.05）. And the same in MDS and ITP group（P〉0.05）. The serum levels of TPO was higher in AA than in MDS and ITP（P〈0.05）. The serum levels of TPO was higher in AL than in MDS and ITP（P〈0. 05）. ①In ITP patients, The serum level of TPO in group of good efficacy of corticosteroids [（233.30±127.85）pg/ml] was lower than the poor efficacy group[（447.06±241.90）pg/ml],P〈0.05. ② The serum level of TPO in AA patients with initial treatment group [（1 979. 67 ± 748. 41） pg/ml]and treatment group [（1 954.55 ± 742.44） pg/ml]were no significant difference,P〉0.05. Conclusion Detecting the serum levels of TPO will contribute to differential diagnosis of thrombocytopenia. The serum TPO level of newly diagnosed ITP patients associated with the efficacy of corticosteroids.

关 键 词：血小板生成素 再生障碍性贫血 免疫性血小板减少症 骨髓增生异常综合征 酶联免疫吸附试验 

分 类 号：R558.2[医药卫生—血液循环系统疾病]