【摘要】 目的了解不同类型急性白血病(AL)在不同病期血小板膜糖蛋白(p-GP)及网织血小板(RP)水平变化规律以及RP与网织血小板绝对计数(RPC)之间的相关关系。方法采用流式细胞仪活细胞直接/间接免疫荧光法测定52例急性白血病患儿初发期及缓解期外周静脉血富含血小板血浆(PRP)CD41、CD42、CD61、CD62p、RP表达水平,并根据患儿不同病期测定RP时的静脉血血小板计数得出其相应的RPC。结果急性白血病患者在初发病期外周血血小板糖蛋白表达水平较正常对照组明显下降(CD41,CD42,CD61均P<0.01,CD62pP<0.05),RP百分比初发病期较正常对照组明显升高(P<0.01),而RPC较对照组明显下降(P<0.01);当经化疗获得缓解时,急性白血病患儿血小板糖蛋白表达也恢复正常,而RP及RPC虽仍略高于对照组,但无统计学差异(均为P>0.05)。AL患者在初发/复发期及缓解期,RP表达百分比与RPC呈一定负相关关系,但经统计学处理无显著性(r=-0.071,P=0.41)。结论AL患者不同病期血小板膜糖蛋白表达水平的变化可能与其骨髓造血微环境变化及骨髓内皮细胞功能改变等有关。在临床上,AL患者接受化疗时可监测其外周血血小板膜糖蛋白水平及RP百分比并计算RPC,有助于判断其骨髓受抑状况,并可根据RP与RPC来决定AL患者化疗后血小板降低时血小板输注与否及输注时机。更多还原

【Abstract】 Objective To find out the changes of platelet glycoprotein(p-GP),and reticulated platelets(RP) levels in patients with acute leukemia(AL) of different stages,and explore the correlation between RP and reticulated platelet counts(RPC) in AL patients of different stages.Methods A total of 52 patients with AL were selected and their venous blood were collected at both incipient and relieved stages for detecting p-GPs(CD41,CD42,CD61,CD62p) and detecting RP expression by flow cytometry.RPC of them was calculated according to the formula RPC=RP×platelet count of whole blood.Results Venous blood p-GPs expression in AL patients of incipient stage decreased significantly than that in control group(CD41,CD42,CD61,all P<0.01;CD62p,P<0.05).RP in AL patients of incipient stage increased than that in control group(P<0.01).But RPC of incipient patients lowered significantly than that of control group(P<0.01).While patients got a relief,blood p-GPs expression of them recovered to normal.However,RP and RPC of them still mildly higher than those of control group,but there was no statistical difference(both P>0.05).In AL children of incipient/relapsed and relieved stage,it showed a mildly negative correlation between RP expression and RPC,but there was no statistical significance (r=-0.071,P=0.41).Conclusion It suggests that combination of RP and RPC may reflect bone marrow megakaryocytopoiesis well particularly in AL patients undergoing chemotherapy.Therefore,monitoring the p-GPs expression or RP and RPC could help hematologist to judge the hematopoietic status or chemotherapy induced bone marrow suppression severity in AL cases.It could also help clinician to make the decision whether a patient needs platelet transfusion or not and what is the best time for platelet transfusion.更多还原