免疫性血小板减少性紫癜患者循环中红细胞微颗粒（RMP）和血小板微颗粒（PMP）增加。

Increased circulating red cell microparticles (RMP) and platelet microparticles (PMP) in immune thrombocytopenic purpura.

机构信息

Department of Internal Medicine, Faculty of Medicine, Assiut University, Egypt.

出版信息

Thromb Res. 2013 Feb;131(2):e59-63. doi: 10.1016/j.thromres.2012.11.021. Epub 2012 Dec 13.

DOI:10.1016/j.thromres.2012.11.021

PMID:23245653

Abstract

UNLABELLED

It has been suggested that patients with ITP have an increased thrombotic risk compared to the general population and compared to those with other causes of acquired thrombocytopenia. The pro-coagulant role of microparticles in some clinical situations has been reported, yet, very little data is available about microparticles in ITP and their effect.

AIM OF THE WORK

To assess the levels of red cell microparticles (RMP), platelet microparticles (PMP) and their possible relation to some haemostatic parameters in ITP patients

PATIENTS AND METHODS

The levels of RMP and PMP in addition to FVIII, FIX, FXI, PC and aPTT were assessed in 29 patients with chronic ITP (8 of them had splenectomy). Ten apparently healthy volunteers served as controls. We compared the levels of the studied parameters in ITP patients with that in controls. Correlations of these parameters with each other and with the platelet count were studied.

RESULTS

RMP (p=0.0001), PMP (p=0.0001), D- dimer (p=0.048), FVIII (p=0.049), FIX (p=0.0001) and FXI (p=0.0001) were significantly higher in ITP patients compared to controls. aPTT was significantly longer in ITP patients (p=0.0001) but PC showed no significant difference. However, RMP was associated with shorter aPTT. Generally, the coagulation factors were negatively correlated with platelet count in ITP patients. Compared to controls, ITP patients preserved higher levels of RMP and PMP even in those with near-normal platelet count. Splenectomy was associated with lower FIX (p=0.0001) and FXI (p=0.028) and higher RMP (p=0.0001).

IN CONCLUSION

Chronic ITP was associated with increased levels of RMP and PMP. FVIII, FIX and FXI were increased in ITP patients but showed a negative correlation with platelet count. Splenectomy was associated with increased levels of RMP and lower levels of FIX and F XI. The high level of microparticles in ITP might point towards a prothrombotic tendency.

摘要

未注明

有人认为 ITP 患者的血栓形成风险高于普通人群，也高于其他获得性血小板减少症患者。已经报道了微颗粒在某些临床情况下的促凝作用，但关于 ITP 患者微颗粒及其作用的数据很少。

目的

评估 ITP 患者红细胞微颗粒（RMP）、血小板微颗粒（PMP）的水平及其与一些止血参数的可能关系。

患者和方法

评估了 29 例慢性 ITP 患者（其中 8 例接受了脾切除术）的 RMP 和 PMP 水平以及 FVIII、FIX、FXI、PC 和 aPTT。10 名健康志愿者作为对照。我们比较了 ITP 患者与对照组之间这些参数的水平。研究了这些参数之间的相关性及其与血小板计数的相关性。

结果

与对照组相比，ITP 患者的 RMP（p=0.0001）、PMP（p=0.0001）、D-二聚体（p=0.048）、FVIII（p=0.049）、FIX（p=0.0001）和 FXI（p=0.0001）显著升高。ITP 患者的 aPTT 显著延长（p=0.0001），但 PC 无显著差异。然而，RMP 与较短的 aPTT 相关。一般来说，在 ITP 患者中，凝血因子与血小板计数呈负相关。与对照组相比，即使血小板计数接近正常，ITP 患者仍保持较高的 RMP 和 PMP 水平。脾切除术与较低的 FIX（p=0.0001）和 FXI（p=0.028）和较高的 RMP（p=0.0001）相关。