IPF相关参数参考范围调查及其在血小板减少性疾病诊断中的探讨

检验医学 ›› 2012, Vol. 27 ›› Issue (9): 745-748.

• 临床检验与血液学检验论著 • 上一篇下一篇

IPF相关参数参考范围调查及其在血小板减少性疾病诊断中的探讨

夏永辉,李筱梅,李勇,幕悦意,张云霞

中国医学科学院北京协和医学院血液学研究所血液病医院检验科，天津 300020

收稿日期:2012-07-09 修回日期:2012-06-07 出版日期:2012-09-12 发布日期:2012-09-12
通讯作者: 李筱梅，联系电话：022-23909064。
作者简介:夏永辉，男，1978年生，学士，主管技师，主要从事临床检验工作。

Research of IPF related parameters and their investigation in diagnosis of thrombocytopenic disease

Department of Clinical Laboratory，Institute of Hematology，Chinese Academy of Medical Science and peking Union Medical College，Tianjin 300020，China

Received:2012-07-09 Revised:2012-06-07 Online:2012-09-12 Published:2012-09-12

摘要/Abstract

摘要： 目的　建立天津地区健康成人未成熟血小板(IPF)相关参数的参考范围及探讨其在血小板减少性疾病鉴别诊断中的价值。方法　采用XE-5000全自动血液分析仪检测天津地区2 600名健康成人外周血中未成熟血小板绝对数[IPF(#)]、未成熟血小板比例[IPF（%）]、高荧光未成熟血小板比例[H-IPF（%）]及血小板计数（PLT），同期测定23例特发性血小板减少性紫癜（ITP）患者、29例急性再生障碍性贫血（AA）患者、10例急性早幼粒细胞白血病（AML-M3）患者、24例AA经抗胸腺细胞球蛋白治疗后缓解（AA-CR）患者外周血的相同参数。比较各疾病组与健康对照组之间各参数的差异，分析各参数在各组疾病中的诊断价值。结果　由健康人群得出95%参考范围分别为IPF(#)：0.7～5.6×109/L；IPF（%）：0.3%～2.8%；H-IPF（%）：0.0%～0.8%；PLT：143～333×109/L；以上参数除PLT外，男、女之间差异有统计学意义（P<0.05）。ITP组和AML-M3组IPF(#)、IPF（%）、H-IPF（%）及PLT 4项参数与健康对照组比较，差异均有统计学意义（P均<0.05）；AA组IPF(#)、IPF（%）及PLT 3项参数与健康对照组比较，差异有统计学意义（P<0.05）；AA-CR组IPF(#)及PLT 2项参数与健康对照组比较，差异有统计学意义（P<0.05）。IPF（%）对ITP的诊断敏感性为90.0%、特异性为95.7%、最大尤登指数为85.7%。IPF（#）对AA的敏感性为90.0%、特异性为100%、最大尤登指数为90%。H-IPF（%）在ITP组和AML-M3的诊断敏感性分别为98.3%、82.5%，特异性分别〖JP2〗为69.7%、90.0%，最大尤登指数分别为77.9%、72.5%。结论　建立了天津地区健康成人的IPF（#）、IPF（%）、〖JP2〗H-IPF（%）的参考范围，并提示不同的PLT相关新参数在不同的血小板减少性疾病中都有一定的临床应用价值。

关键词: 未成熟血小板, 血小板, 血小板减少性疾病, 全自动血液分析仪

Abstract: Objective　To establish the healthy subjects′ immature platelet fraction (IPF) parameter reference range in Tianjin，and to investigate its significance in the diagnosis of thrombocytopenic disease. Methods　By XE-5000 automatic hematology analyzer，2 600 healthy subjects′ peripheral blood absolute value of immature platelet fraction [IPF(#)]，the percentage of immature platelet fraction [IPF(%)]，the percentage of high fluorescence immature platelet fraction[H-IPF(%)] and platelet(PLT) in Tianjin were detected. These parameters in 23 patients with idiopathic thrombocytopenic purpura (ITP)，29 patients with acute aplastic anemia (AA)，10 patients with acute promyelocytic leukemia ( AML-M3 ) and 24 patients with AA treated with anti-thymocyte globulin remission after treatment ( AA-CR ) were detected. The differences between disease group with various diseases and the healthy control group were compared，and the parameter diagnosis significances in various diseases were analyzed. Results　For healthy control group，the 95% reference ranges were IPF (#)： 0.7-5.6×109/L，IPF (%)： 0.3%-2.8%，H-IPF(%)：0.0%-0.8% and PLT:143-333×109/L. The above parameters except PLT had statistical significance between males and females (P<0.05 ). In ITP group and AML-M3 group，IPF(#)，IPF(%)，H-IPF(%) and PLT had statistical significance compared with healthy control group (P<0.05 ). In AA group，IPF(#)，IPF(%) and PLT had statistical significance compared with healthy control group(P<0.05 ). In AA-CR group，IPF(#) and PLT had statistical significance compared with healthy control group(P<0.05 ). The sensitivity of IPF(%) in ITP group was 90.0%，the specificity was 95.7% and the largest Youden index was 85.7%. The sensitivity of IPF (#) in AA group was 90.0%，the specificity was 100%，and the largest Youden index was 90%. The sensitivities of H-IPF (%) in ITP group and AML-M3 group were 98.3% and 82.5%，the specificities were 69.7% and 90.0%，and the largest Youden indices were 77.9% and 72.5%. Conclusions　The reference ranges of IPF(#)，IPF (%) and H-IPF (%) among healthy subjects in Tianjin are established，and the different PLT parameters in different thrombocytopenia disease have certain clinical significance.

Key words: Immature platelet fraction, Platelet, Thrombocytopenic disease, Automatic hematology analyzer

夏永辉;李筱梅;李　勇;幕悦意;张云霞. IPF相关参数参考范围调查及其在血小板减少性疾病诊断中的探讨[J]. 检验医学, 2012, 27(9): 745-748.

XIA Yonghui;LI Xiaomei;LI Yong;MU Yueyi;ZHANG Yunxia. Research of IPF related parameters and their investigation in diagnosis of thrombocytopenic disease[J]. , 2012, 27(9): 745-748.

参考文献

[1]陈军浩，张葵. 流式细胞仪计数网织血小板及初步临床应用[J]. 临床检验杂志，2001，19（6）：337-338.
[2]张之南，沈悌. 血液病诊断及疗效标准[M]. 第2版. 北京：北京科学技术出版社,1998:279-284.
[3]National Committee for Clinical Laboratoy Standards. How to define and determine reference intervals in the clinical laboratory; approved guideline[S]. 2nd edition. C28-A2，NCCLS，2000.
[4]陈卫中，倪宗瓒，潘晓平，等.用ROC曲线确定最佳临界点和可疑值范围[J]. 现代预防医学，2005，32（7）:729-731.
[5]Kurata Y，Hayashi S，Kiyoi T，et al.Diagnostic value of tests for reticulated platelets，plasma glycocalicin，and thrombopoietin levels for discriminating between hyperdestructive and hypoplastic thrombocytopenia[J].Am J Clin Pathol，2001，115(5):656-664.
[6]Jilma-Stohlawetz P，Homoncik M，Jilma B，et al.High levels of reticulated platelets and thrombopoietin characterize fetal thrombopoiesis[J].Br J Haematol，2001，112(2):466-468.
[7]Bowles KM，Cooke LJ，Richards EM，et al. Platelet size has diagnostic predictive value in patients with thrombocytopenia[J]. Clin lab Haematol，2005，27(6):370-373.
[8]丛玉隆，乐家新．北京市成人静脉血各种血细胞参数正常参考范围调查[J]. 中华医学检验杂志，1996，19(3)：179-181．
[9]陈伟，胡波，邓光贵．重庆市3 015例健康成人静脉血细胞各参数参考范围调查[J]．中华检验医学杂志，2000，23(1)：48．
[10]丛玉隆，金大鸣，王鸿利，等. 中国人群成人静脉血细胞分析参考范围调查[J]. 中华医学杂志，2003，83 (14)：1201-1205.
[11]沈建成，葛国兴. 绍兴市成人静脉血血细胞22项参数参考值调查[J]. 检验医学，2006，21（1）：68-70.
[12]吴佳学，季海生. 沂蒙山区健康人群血细胞及其相关指标分析[J]. 检验医学，2007，22（3）：263-267.
[13]杨斌，曹祥山，邱国强，等.网织血小板在血小板减少性疾病中的临床意义[J]. 临床内科杂志，2005，22(12)：796.

IPF相关参数参考范围调查及其在血小板减少性疾病诊断中的探讨

Research of IPF related parameters and their investigation in diagnosis of thrombocytopenic disease

RichHTML

PDF (PC)

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics