目的 探讨血小板参数与骨髓病态巨核细胞计数和分类在原发性血小板增多症 (ET) 与继发性血小板增多症 (RT) 鉴别诊断中的意义.方法 30例ET患者为ET组, 30例RT患者为RT组, 两组患者分别进行血小板参数[血小板计数 (PLT) 、平均血小板体积 (MPV) 、血小板压积 (PCT) 、血小板分布宽度 (PDW) ]和骨髓病态巨核细胞计数与分类, 并进行比较.结果 ET组患者PLT、PCT、PDW水平分别为 (772.00±125.30) ×109/L、 (0.60±0.17) ％、 (18.00±0.79) ％, 显著高于RT组的 (564.00±83.20) ×109/L、 (0.45±0.12) ％、 (16.40±0.92) ％, MPV (6.04±0.51) fl显著低于RT组的 (7.88±0.65) fl, 差异有统计学意义 (P＜0.05) .ET组患者单圆核巨核细胞检出率10.0％高于RT组的6.7％, 但差异无统计学意义 (P＞0.05) .ET组患者多分叶巨核细胞以及小巨核细胞检出率53.3％、36.7％均显著高于RT组的13.3％、0, 差异有统计学意义 (P＜0.05) .结论 血小板参数PLT、MPV、PCT、PDW和骨髓病态巨核细胞检出率在初步鉴别ET与RT中具有重要意义, 可作为鉴别诊断的重要依据之一.%Objective To discuss the significance of platelet parameters and bone marrow morbid megakaryocytes in differential diagnosis of essential thrombocytosis (ET) and secondary thrombocytosis (RT). Methods There were 30 ET patients as ET group and 30 RT patients as RT group. Platelet parameters [platelet (PLT) count, mean platelet volume (MPV) , plateletcrit (PCT) , platelet distribution width (PDW) ] and bone marrow pathological megakaryocyte count and classification were performed and compared in the two groups. Results ET group had significantly higher PLT, PCT and PDW level respectively as (772.00±125.30) ×109/L, (0.60±0.17) ％ and (18.00±0.79) ％ than (564.00±83.20) ×109/L, (0.45±0.12) ％, (16.40±0.92) ％ in RT group, and significantly lower MPV as (6.04±0.51) fl than (7.88±0.65) fl in RT group. Their difference was statistically significant (P＜0.05). ET group had higher detection rate of mononuclear megakaryocytes as 10.0％ than 6.7％ in RT group, but the difference was not statistically significant (P＞0.05). ET group had significantly higher detection rate of multilobular megakaryocytes and Micromegakaryocytes as 53.3％ and 36.7％ than 13.3％ and 0 in RT group.Their difference was statistically significant (P＜0.05). Conclusion The detection rates of platelet parameters PLT, MPV, PCT, PDW and bone marrow pathological megakaryocytes are of great significance in the preliminary identification of ET and RT, and can be used as an important basis for differential diagnosis.
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