Ault K A, Rinder H M, Mitchell J, Carmody M B, Vary C P, Hillman R S
Maine Medical Center Research Institute, Department of Medicine, Portland 04106.
Am J Clin Pathol. 1992 Dec;98(6):637-46. doi: 10.1093/ajcp/98.6.637.
Direct flow cytometric measurement of nucleic acid content in individual platelets is possible using the fluorescent dye Thiazole Orange (Becton-Dickinson, San Jose, CA). When applied to studies of thrombocytopenic patients, platelets with elevated nucleic acid content ("reticulated platelets") can be identified and quantitated. Labeling of these platelets is saturable and is abolished by treatment with RNAse. It has been suggested that, similar to the erythrocyte reticulocyte response to anemia, the number of these platelets appearing in the circulation may provide an estimate of the rate of thrombopoiesis. The authors studied 229 thrombocytopenic patients, measuring both reticulated platelets and platelet-associated immunoglobulin. The results show that for the subset of patients with normal levels of platelet-associated immunoglobulin, the average absolute number of reticulated platelets is independent of platelet count and remains in the normal range. For those with elevated levels of platelet-associated immunoglobulin, the absolute number of reticulated platelets increases in patients who are moderately thrombocytopenic (60 to 100 x 10(9)/L) but decreases to normal or subnormal levels as thrombocytopenia worsens. The latter finding has been duplicated in studies of mice made thrombocytopenic by injection of anti-platelet antiserum. These results are consistent with the hypothesis that reticulated platelets are subject to peripheral destruction at the same rate as mature platelets, and that in the severely thrombocytopenic patient their level may decrease despite an appropriate marrow thrombopoietic response.
使用荧光染料噻唑橙（加利福尼亚州圣何塞市贝克顿-迪金森公司）可直接通过流式细胞术测量单个血小板中的核酸含量。将其应用于血小板减少症患者的研究时，核酸含量升高的血小板（“网织血小板”）可被识别和定量。这些血小板的标记是可饱和的，并且用核糖核酸酶处理后标记会消失。有人提出，类似于红细胞网织红细胞对贫血的反应，循环中出现的这些血小板数量可能提供血小板生成速率的估计值。作者研究了229例血小板减少症患者，同时测量了网织血小板和血小板相关免疫球蛋白。结果表明，对于血小板相关免疫球蛋白水平正常的患者亚组，网织血小板的平均绝对数量与血小板计数无关，且保持在正常范围内。对于血小板相关免疫球蛋白水平升高的患者，中度血小板减少（60至100×10⁹/L）的患者中网织血小板的绝对数量增加，但随着血小板减少症加重，其数量会降至正常或低于正常水平。在通过注射抗血小板抗血清使小鼠血小板减少的研究中也重复了后一发现。这些结果与以下假设一致，即网织血小板与成熟血小板以相同速率遭受外周破坏，并且在严重血小板减少症患者中，尽管骨髓有适当的血小板生成反应，其水平仍可能降低。
