儿童急性淋巴细胞白血病血小板参数及血小板膜糖蛋白临床意义研究  

A study on platelet indices and platelet membrane glycoprotein in children with acute lymphocytic leukemia

作　　者：黄喆 刘文君 曹汴川 罗锋 胡晓 陈红英 刘春艳 沈红书[4] 

机构地区：[1]西南医科大学附属医院儿一科,四川泸州646000 [2]西南医科大学附属医院感染呼吸科,四川泸州646000 [3]四川省资阳市中心血站,四川资阳641300 [4]四川省绵阳市中心医院,四川绵阳621000

出　　处：《中国实用儿科杂志》2017年第5期366-370,共5页Chinese Journal of Practical Pediatrics

基　　金：四川省卫生厅科研基金资助(20110004)

摘　　要：目的探讨儿童急性淋巴细胞白血病(ALL)时血小板活化状态及功能的变化。方法研究对象均来自西南医科大学附属医院2012年6月至2013年11月收治的住院患儿,应用全自动血细胞分析仪和流式细胞术(FCM)微量全血法检测ALL患儿(ALL组)、ALL诱导缓解治疗达完全缓解患儿(ALL-CR1组)以及外科择期手术患儿(正常组)的血小板参数、网织血小板百分率(IPF%)、网织血小板绝对值(IPC)、颗粒膜糖蛋白(CD62p)、PAC-1。结果二磷酸腺苷(ADP)激活前,ALL组CD62p、PAC-1表达高于正常组(P<0.05),ALL-CR1组PAC-1表达高于正常组(P<0.05),低于ALL组(P<0.05);ADP激活后,ALL组CD62p、PAC-1表达低于正常组(P<0.05),ALL-CR1组PAC-1表达低于正常组(P<0.05),高于ALL组(P<0.05);ALL组血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)均低于正常组和ALL-CR1组(P<0.05);ALL组IPF%高于正常组和ALL-CR1组(P<0.05),IPC低于正常组和ALL-CR1组(P<0.05)。结论ALL初诊患儿存在血小板活化,同时伴有血小板功能异常。血小板参数及血小板膜糖蛋白可作为判断ALL疗效的有效指标。Objective To investigate the change of the platelet state and function in acute lymphocytic leukemia. Methods The changes of platelet indices （PLT, PCT, MPV, PDW） , immature platelet fraction （IPF%） , immature platelet counts （IPC）, granule membrane glycoprotein of platelet （CD62p） and PAC-1 were obtained by using automatic blood cell analyzer and whole blood flow eytometry （FCM） respectively, in children with acute lymphocytic leukemia （ALL） , ALL in first complete remission （ALL-CR1） and children undergoing elective surgical procedure （control group）. Results （ 1 ） Without addition of platelet agonists ADP, expression of platelet surface activated CD62p and PAC-1 in ALL was higher than that in control group （P〈 0.05） , while expression of platelet surface activated PAC-1 in ALL-CR 1 was higher than that in control group （P 〈 0.05 ）, and lower than that in ALL （P 〈 0.05 ） ; （2）With addition of platelet agonists ADP, expression of platelet surface activated CD62p and PAC- 1 in ALL was lower than that in eontrol group （P 〈 0.05） , while expression of platelet surface activated PAC-1 in ALL-CRI was lower than that in control group （P 〈 0.05 ）, and higher than that in ALL （P 〈 0.05 ） ; （ 3 ） PLT, PCT and MPV in ALL was lower than that in control group and ALL-CR1 （P〈0.05） ; （4） IPF% in ALL was higher than that in control group and ALL-CR1 （P 〈 0.05）, and IPC was lower than that in control group and ALL-CR 1 （P 〈 0.05）. Conclusion The children who are newly diagnosed with acute lymphocytic leukemia have peripheral platelet reactivity and platelet function defects.Platelet indices and platelet membrane glycoprotein can be used as effective indicators to judge the effect on ALL.

关 键 词：急性淋巴细胞白血病 血小板参数 PAC-1 颗粒膜糖蛋白 血小板功能 

分 类 号：R72[医药卫生—儿科]