Hayashi S, Oshida M, Kiyoi T, Tadokoro S, Kashiwagi H, Honda S, Tomiyama Y, Kurata Y
Department of Blood Transfusion, Osaka University Hospital.
Rinsho Ketsueki. 2000 Sep;41(9):705-11.
Measurements of plasma glycocalicin (GC) and reticulated platelets (RP) have been reported to be useful for classifying thrombocytopenic disorders. However, there have been no reports comparing the clinical usefulness of the two methods. We measured GC and RP levels simultaneously in 39 patients with idiopathic thrombocytopenic purpura (ITP), 15 patients with aplastic anemia (AA), and 17 patients with hypoplastic thrombocytopenia (HypoT) due to chemotherapy. The GC index (GC level normalized for the individual platelet count) and the percentage of RP (%RP), a parameter of platelet life span, were very high (7.5 +/- 11.4 and 20.8 +/- 13.0%, respectively) in patients with ITP as compared with those of healthy subjects (1.3 +/- 0.5 and 7.9 +/- 2.5%, respectively). However, 6 AA patients and 14 HypoT patients, in whom platelet life span is thought to be normal, also had an elevated GC index, suggestive of a false positive result. The RP, a parameter of platelet production, was low in all AA and HypoT patients except for one in each case. However, the GC level, an additional parameter of platelet production, was normal in 4 AA and 8 HypoT patients, indicating that it is not a sensitive indicator. We conclude that the RP and %RP are more feasible markers of thrombopoiesis and platelet life span, respectively, than the GC level and GC index.
据报道，血浆糖萼素（GC）和网织血小板（RP）的检测对于血小板减少症的分类很有用。然而，尚无关于比较这两种方法临床实用性的报道。我们同时检测了39例特发性血小板减少性紫癜（ITP）患者、15例再生障碍性贫血（AA）患者和17例因化疗导致的低增生性血小板减少症（HypoT）患者的GC和RP水平。与健康受试者（分别为1.3±0.5和7.9±2.5%）相比，ITP患者的GC指数（根据个体血小板计数进行标准化的GC水平）和RP百分比（%RP，血小板寿命的一个参数）非常高（分别为7.5±11.4和20.8±13.0%）。然而，6例AA患者和14例HypoT患者，其血小板寿命被认为是正常的，也有GC指数升高，提示假阳性结果。除各有1例例外，所有AA和HypoT患者的RP（血小板生成的一个参数）均较低。然而，4例AA患者和8例HypoT患者的GC水平（血小板生成的另一个参数）正常，表明它不是一个敏感指标。我们得出结论，与GC水平和GC指数相比，RP和%RP分别是更可行的血小板生成和血小板寿命标志物。
