肝硬化患者网织血小板和血小板参数的临床应用价值

摘要

目的：探讨肝硬化患者网织血小板与血小板参数的临床应用价值及其与Child-Pugh肝功能分级的关系。方法选择2014年1月至2015年8月于本院住院并确诊为肝硬化的162例患者作为观察组，其中Child-Pugh A级65例，Child-Pugh B级56例，Child-Pugh C级41例。选取同期于本院体检中心正常健康体检者50例为对照组。应用Sysmex XN-9000全自动血球分析仪流水线检测所有受检者的网织血小板（reticulated platelet，RP）、血小板（platelet，PLT）及其参数。结果①与健康对照组比较：观察组RP和PT值显著降低，未成熟网织血小板比率（immature platelet fraction，IPF）、大血小板比率（platelet-large cell ratio，P-LCR）、血小板体积分布宽度（platelet distribution width，PDW）和平均血小板体积（mmean platelet volume，MPV）显著升高，差异有统计学意义（P值均为0.001）；②按Child-Pugh标准分级显示：随Child-Pugh分级的递增，IPF、MPV、PDW和P-LCR值逐渐升高，PLT和RP值则逐渐降低，且3组间差异显著（P值均为0.001）。结论网织血小板（RP、IPF）和血小板参数（PLT、MPV、PDW、P-LCR）可以有效评估肝硬化程度，可判断和评估肝硬化实质损害程度及病情，为临床医生制定合理的治疗方法及预防方案提供可靠依据。%ObjectiveTo investigate the clinical value of reticulated platelet and platelet parameter in patients with liver cirrhosis and its relationship with Child-Pugh.MethodsTotal of 162 patients with liver cirrhosis from January 2014 to August 2015 in our hospital were selected as the observation group, of whom Child-Pugh A grade were 65 cases, Child-Pugh B grade were 56 cases and Child-Pugh C grade were 41 cases. Fifty cases of healthy controls were selected in the same period. XN-9000 Sysmex automatic blood cell analyzer was used to detect the network of platelet, platelet and its parameters.Results①Compared with healthy control group, the reticulated platelet (RP) and platelet (PLT) values decreased signiifcantly, but the value of immature platelet fraction (IPF), mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) increased signiifcantly, the differences were statistically signiifcant (P = 0.001);②According to Child-Pugh standard grading display: with Child Pugh grade increasing, the IPF, MPV, PDW and P-LCR value increased gradually, PLT and RP value decreased gradually and the differences were statistically signiifcant among the three groups (P= 0.001).Conclusion Reticulated platelet (RP and IPF) and platelet parameter (PLT, MPV, PDW and P-LCR) can effectively evaluate the degree of liver cirrhosis and can be used as clinical evaluation and assessment indicators of the severity of cirrhosis, which can provide a reliable basis for clinicians to develop reasonable treatment and prevention.