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目的探讨网织血小板(RPs)、血小板生成素(TPO)与系统性红斑狼疮(SLE)患者血小板减少的关系。方法48例SLE患者依据血小板计数(BPC)分为BPC正常组22例,BPC降低组26例和20例正常对照组,均通过流式细胞仪(FCM),放射免疫分析法(RIA),检测3组外周血网织血小板百分比(RP%)、TPO,并对部分患者进行骨髓巨核细胞(MK)直接计数。结果26例BPC降低组RP%(16.8±0.5)%、网织血小板绝对值RPC(3.7±0.6)×109/L与22例BPC正常组、正常对照组相比,均差异有显著性(P<0.01)。血小板减少或正常的SLE患者,其TPO水平分别为(47±6)、(49±6)pg/ml与正常对照组相比差异均有显著性(P<0.01)。SLE患者BPC降低组MK升高(15/26),SLE患者BPC正常组MK升高不明显(5/22)。结论①血小板减少的SLE患者RP%及RPC显著升高,提示外周血小板破坏可能是其主要原因。②SLE患者的TPO水平明显升高,提示SLE患者均存在巨核细胞的成熟障碍。
Objective To investigate the relationship between platelet count (RPs), thrombopoietin (TPO) and thrombocytopenia in patients with systemic lupus erythematosus (SLE). Methods Forty-eight patients with SLE were divided into 22 cases of normal BPC group, 26 cases of BPC reduced group and 20 cases of normal control group according to platelet count (BPC). All of them were detected by flow cytometry (FCM), radioimmunoassay (RIA) Three groups of peripheral blood platelet percentage of platelets (RP%), TPO, and some patients with bone marrow megakaryocytes (MK) direct count. Results Compared with the normal control group, the percentages of RP% (16.8 ± 0.5)% in 26 cases of BPC reduction group and RPC (3.7 ± 0.6) × 109 / L of platelet reticulation platelets were significantly different from those in the normal control group (P <0.01). Thrombocytopenia or normal SLE patients, the TPO levels were (47 ± 6), (49 ± 6) pg / ml, compared with the normal control group, the difference was significant (P <0.01). SLE patients with BPC decreased MK group (15/26), SLE patients with normal BPC MK increased significantly (5/22). Conclusions ① Thrombocytopenia in patients with SLE RP% and RPC significantly increased, suggesting that peripheral platelet destruction may be the main reason. ② TPO levels in patients with SLE were significantly elevated, suggesting that patients with SLE have megakaryocyte maturation disorder.