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印度中部血小板减少症患者的病因学概况:一项三级中心研究。

Etiological Profiles of Patients With Thrombocytopenia in Central India: A Tertiary Centre Study.

作者信息

Verma Deepshikha, Yadav Ranjan, Rampuri Varsha, Choudhary Rajni, Awasthi Abhiram

机构信息

Department of Pathology, Gandhi Medical College and Hamidia Hospital, Bhopal, IND.

Department of Orthopaedic Surgery, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Dec 15;14(12):e32571. doi: 10.7759/cureus.32571. eCollection 2022 Dec.

Abstract

Introduction Platelet-related disease may result from an abnormal platelet count, namely thrombocytopenia or thrombocythemia, or altered platelet function, and thus is associated with bleeding or with thrombotic manifestation. Thrombocytopenia is defined as a subnormal number of platelets i.e. less than 1,50,000/µL in the peripheral blood. It can lead to inadequate clot formation and increased risk of bleeding and is a common indication for bone marrow aspiration and biopsy. Methodology The study was a hospital-based prospective observational study from January 2019 to June 2020. All cases of thrombocytopenia which were diagnosed first on haematology analyser (platelet counts <150,000/µL) and confirmed subsequently by peripheral smear with/without bleeding manifestations due to thrombocytopenia were taken up for the study. The aims and objectives of this study were to find out the epidemiological spectrum and prevalence of thrombocytopenia according to age and sex along with the correlation of haematological and bone marrow findings of such patients. Result This study comprised 100 cases of thrombocytopenia, with acute leukaemia accounting for the majority (28/100), followed by dimorphic anaemia (15/100), megaloblastic anaemia (11/100), hypocellular marrow, infection, and other conditions. All cases (100%) displayed the clinical symptom of widespread weakness and pallor, which was followed by fatiguability (72%) and dyspnoea (48%). Many thrombocytopenic individuals also had lymphadenopathy and hepatomegaly, the last two least common appearances. Lymphadenopathy and hepatomegaly which were the last two least common presentations were present in a significant number of thrombocytopenic patients. Conclusion The study of bone marrow is helpful in the diagnosis of thrombocytopenia cases. Bone marrow examination is a simple, safe outpatient procedure and yields an impressive amount of diagnostically valuable data in a wide variety of disorders of thrombocytopenia. An evaluation of the patient's bone marrow unquestionably aids in the early diagnosis and treatment of their ailment.

摘要

引言 血小板相关疾病可能由血小板计数异常引起,即血小板减少症或血小板增多症,或者血小板功能改变,因此与出血或血栓形成表现相关。血小板减少症定义为外周血中血小板数量低于正常水平,即低于150,000/µL。它可导致凝血形成不足并增加出血风险,是骨髓穿刺和活检的常见指征。

方法 本研究为2019年1月至2020年6月基于医院的前瞻性观察性研究。所有首次通过血液分析仪诊断为血小板减少症(血小板计数<150,000/µL)且随后经外周血涂片确认(无论有无因血小板减少症导致的出血表现)的病例均纳入本研究。本研究的目的是根据年龄和性别找出血小板减少症的流行病学谱和患病率,以及此类患者血液学和骨髓检查结果的相关性。

结果 本研究包括100例血小板减少症病例,其中急性白血病占大多数(28/100),其次是双相性贫血(15/100)、巨幼细胞贫血(11/100)、骨髓细胞减少、感染及其他情况. 所有病例(100%)均表现出全身虚弱和苍白的临床症状,其次是易疲劳(72%)和呼吸困难(48%)。许多血小板减少症患者还伴有淋巴结病和肝肿大,后两者是最不常见的表现。相当数量的血小板减少症患者存在最不常见的后两种表现,即淋巴结病和肝肿大。

结论 骨髓检查有助于血小板减少症病例诊断。骨髓检查是一种简单、安全的门诊检查方法,并能产生大量对各种血小板减少症疾病具有诊断价值的数据。对患者骨髓进行评估无疑有助于早期诊断和治疗其疾病。

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