原发性血小板增多症基因突变型与中医证型及血栓危度相关性  

Correlation between gene mutation of essential thrombocythemia and TCM syndrome type and thrombus risk

作　　者：周玉才 孙浩 岳涛 汤久慧 李迎巧 王茂生 孙长勇 胡笑赢 ZHOU Yucai;SUN Hao;YUE Tao(Department of Hematology,Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000,China)

机构地区：[1]廊坊市中医医院血液科,河北廊坊065000

出　　处：《四川中医》2024年第12期4-6,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：廊坊市科学技术局(编号:2021013011)。

摘　　要：目的:探究原发性血小板增多症基因突变型与中医证型及血栓危度相关性。方法:回顾性选取廊坊市中医医院2016年12月~2020年01月收治的78例原发性血小板增多症患者的临床资料为研究对象,并根据患者的驱动基因突变类型将其分为CALR组、JAK2组和三阴组。比较三组患者的临床资料、中医证型、血清学指标、血栓危险程度和预后分级情况。结果:78例原发性血小板患者中,CALR基因突变患者22例,占比28.21%;JAK2基因突变患者40例,占比51.28%;MPL基因突变患者4例,占比5.13%;三阴型患者12例,占比15.38%。三组患者的中医证型均以气滞血瘀证为主,其次为气虚血瘀证和肾虚血瘀证。三组患者的中医证型进行比较,差异无统计学意义(P>0.05)。三组患者的白细胞数、血红蛋白水平进行比较,差异有统计学意义(P<0.05);三组患者的血小板数、纤维蛋白原水平进行比较,差异无统计学意义(P>0.05)。三组患者的血栓危险程度进行比较,差异有统计学意义(P<0.05)。三组患者的预后分级情况进行比较,差异有统计学意义(P<0.05)。结论:原发性血小板增多症基因突变型与血栓危度具有一定的相关性,临床可根据不同基因型来预测患者的血栓危度和预后情况。Objective:To explore the correlation between gene mutation of essential thrombocythemia and traditional Chinese medicine(TCM)syndrome type and thrombus risk.Methods:The clinical data of 78patients with essential thrombocythemia admitted to Langfang Hospital of Traditional Chinese Medicine from October 2016to October 2020were retrospectively selected as the study objects,and the patients were divided into CALR group,JAK2group and negative group according to their driver gene mutation types.The clinical data,TCM syndrome type,serological index,thrombus risk degree and prognosis grade of the three groups were compared.Results:Among 78patients with essential platelet,22patients with CALR gene mutation,accounting for 28.21%;there were 40patients with JAK2gene mutation,accounting for 51.28%.Three Yin type 12cases,accounting for 15.38%;4patients with MPL gene mutation,accounting for 5.13%.The TCM syndromes of the three groups are mainly qi stagnation and blood stasis,followed by qi deficiency and blood stasis and kidney deficiency and blood stasis.There was no significant difference in TCM syndrome types among the three groups(P>0.05).The white blood cell count and hemoglobin level of the three groups were compared,and the difference was statistically significant(P<0.05).There was no significant difference in platelet count and fibrinogen level among the three groups(P>0.05).The risk of thrombosis in the three groups was compared,and the difference was statistically significant(P<0.05).The prognosis grading of the three groups was compared,and the difference was statistically significant(P<0.05).Conclusion:There is a certain correlation between the gene mutation of primary thrombocytosis and the risk of thrombosis,and the risk of thrombosis and prognosis of patients can be predicted according to different genotypes.

关 键 词：原发性血小板增多症 基因突变型 中医证型 血栓危度 相关性分析 

分 类 号：R558.3[医药卫生—血液循环系统疾病]