巨核细胞在ITP患者中的诊断价值及治疗后HPA的表达效果  

Diagnostic Value of Megakaryocytes in ITP Patients and Expression Effect of HPA after Treatment

作　　者：冯于 刘学文[1] 刘明君 张坤[1] 卓丽霞 FENG Yu;LIU Xuewen;LIU Mingjun;ZHANG Kun;ZHUO Lixia(Department of Hematology,the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia Autonomous Region,014030 China;Department of Hematology,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia Autonomous Region,014010 China)

机构地区：[1]内蒙古科技大学包头医学院第二附属医院血液内科,内蒙古包头014030 [2]内蒙古科技大学包头医学院第一附属医院血液内科,内蒙古包头014010

出　　处：《系统医学》2022年第22期14-17,22,共5页Systems Medicine

基　　金：包头市科技计划项目(2020Z1008-5)。

摘　　要：目的探究巨核细胞在原发性免疫性血小板减少性紫癜(idiopathic thrombocytoenia purpura,ITP)患者中的诊断价值及治疗后人类血小板抗体(human platelet antibody,HPA)的表达效果。方法选取2020年11月—2021年11月包头医学院第一附属医院和包头医学院第二附属医院收治的ITP患者57例(ITP组),另选取同期正常者56名(正常组)。观察骨髓巨核细胞的形态学改变对ITP诊断价值。将57例ITP患者按HPA值分为<1∶10组、1∶10组、>1∶10组。分析HPA在ITP患者中的表达。结果ITP组原幼型巨核细胞MK计数(12.15±1.30)个/1.5×3.0 cm高于正常组(5.78±1.00)个/1.5×3.0 cm,颗粒型MK计数(69.78±14.07)个/1.5×3.0 cm高于正常组(53.49±10.77)个/1.5×3.0 cm,产板型MK计数(9.70±7.15)个/1.5×3.0 cm低于正常组(36.87±11.25)个/1.5×3.0 cm,差异有统计学意义(t=-29.159、-6.092、15.350,P<0.001)。ITP组胞浆量高于正常组,退行性变量高于正常组,颗粒量(伴有成熟障碍)低于正常组,差异有统计学意义(P<0.05)。颗粒型MK、原幼型MK、产板型MK、颗粒量、退行性变量、细胞浆量的AUC面积分别为0.913、0.908、0.902、0.893、0.862、0.858。HPA>1∶10组短期有效率(100.00%)高于<1∶10组(90.00%)、1∶10组(89.29%),差异有统计学意义(P<0.05)。结论骨髓巨核细胞形态学变化可有效诊断ITP,HPA>1∶10组的短期有效率更高,对ITP治疗效果具有一定的预测价值。Objective To investigate the diagnostic value of megakaryocytes in Idiopathic thrombocytoenia purpura(ITP)patients and the expression effect of human platelet antibody(HPA)after treatment.Methods 57 ITP patients admitted to the Second Affiliated Hospital of Baotou Medical College and the Second Affiliated Hospital of Baotou(ITP group)Medical College from November 2020 to November 2021 and 56 normal subjects during the same period(normal group)were selected.To observe the morphological changes of megakaryocytes in bone marrow for the diagnosis of ITP.57 ITP patients were divided into<1∶10 group,1∶10 group and>1∶10 group according to HPA value.The expression of HPA in ITP patients was analyzed.Results The number of prokaryotic megakaryocytes MK in ITP group(12.15±1.30)/1.5×3.0 cm was higher than that in normal group(5.78±1.00)/1.5×3.0 cm the number of particle MK(69.78±14.07)/1.5×3.0 cm was higher than that of normal group(53.49±10.77)/1.5×3.0 cm the MK count of plate type(9.70±7.15)/1.5×3.0 cm was lower than that of normal group(36.87±11.25)/1.5×3.0 cm the difference was statistically significant(t=-29.159,-6.092,15.350,P<0.001).The amount of cytoplasm in ITP group was higher than that in normal group,the regressive variables were higher than those in normal group,particle size(with maturation disorder)was lower than that of normal group,the difference was statistically significant(P<0.05).The AUC areas of granular MK,protoyoung MK,plate-producing MK,particle size,degenerative variable and cytoplasm volume were 0.913,0.908,0.902,0.893,0.862 and 0.858,respectively.The short-term effective rate of HPA>1∶10 group was 100.00%higher than that of HPA<1∶10 group(90.00%)and 1∶10 group(89.29%),the difference was statistically significant(P<0.05).Conclusion The morphological changes of bone marrow megakaryocytes can effectively diagnose ITP,and the shortterm effective rate is higher in HPA>1∶10 group,which has certain predictive value for the treatment effect of ITP.

关 键 词：巨核细胞 原发性免疫性血小板减少性紫癜 人类血小板抗体 

分 类 号：R59[医药卫生—内科学]