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[未成熟血小板分数(IFP%)在血小板减少症诊断中的评估]

[Assessment of an immature platelet fraction (IFP%) in the diagnosis of thrombocytopenia].

作者信息

Cannavo Isabelle, Ferrero-Vacher Corinne, Sudaka Isabelle, Aquaronne Danielle, Berthier Frédéric, Raynaud Sophie

机构信息

Laboratoire d'hématologie, Hôpital de Cimiez, Nice.

出版信息

Ann Biol Clin (Paris). 2010 Jul-Aug;68(4):415-20. doi: 10.1684/abc.2010.0449.

Abstract

Reticulated platelets are young platelets containing mRNA. They reflect the rate of thrombopoesis. The aim of this study was to evaluate the reliability of the percentage of reticulated platelets (IPF%) as a diagnostic test for thrombocytopenia pathogenesis. IPF% was measured using XE 2100 Sysmex. An IPF% reference range in 52 healthy individuals was established as 1-4.5% with a median 2.2%. In all the 13 patients with idiopathic thrombocytopenic purpura IPF% was increased (median 11.8, range 5.3-54.3%). Only 7 out of 18 patients with disseminated intravascular coagulation had high IPF% (median 5.4%, range 2.9-14.1%). Surprisingly, IPF% was increased in 17 out of 22 patients with acute leukaemia (median 9.7%, range 0.9-41.9%). In CIVD, IPF% values correlated with the severity of the illness. Increased values in acute leukaemia could not be explained by non specific staining but by delayed maturation of reticulated platelets. A high IPF% does not substantiate hyperdestructive thrombocytopenia but a diagnosis of idiopathic thrombocytopenic purpura should be questioned if IPF% is not raised.

摘要

网织血小板是含有信使核糖核酸的年轻血小板。它们反映了血小板生成的速率。本研究的目的是评估网织血小板百分比(IPF%)作为血小板减少症发病机制诊断试验的可靠性。使用XE 2100 Sysmex测定IPF%。52名健康个体的IPF%参考范围确定为1 - 4.5%,中位数为2.2%。在所有13例特发性血小板减少性紫癜患者中,IPF%升高(中位数为11.8,范围为5.3 - 54.3%)。18例弥散性血管内凝血患者中只有7例IPF%升高(中位数为5.4%,范围为2.9 - 14.1%)。令人惊讶的是,22例急性白血病患者中有17例IPF%升高(中位数为9.7%,范围为0.9 - 41.9%)。在慢性炎症性血管病(CIVD)中,IPF%值与疾病严重程度相关。急性白血病中IPF%升高不能用非特异性染色解释,而是由于网织血小板成熟延迟。高IPF%不能证实血小板过度破坏,但如果IPF%未升高,则应质疑特发性血小板减少性紫癜的诊断。

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