| Objective: Thrombopoietin (TPO) is the primary physiologicalregulator of megakaryopoiesis and thrombopoiesis. It promotes the proliferation and differentiation of megakaryocyte progenitors, stimulates megakaryocyte maturation, and results in increased platelet production by binding to its receptor c-mpl. The studies show that TPO is closely related to the blood diseases. The objective of the study was to detect the serum levels of TPO in children with AITP and CITP, to investigate the role of TPO in the pathophysiology of thrombocytopenic in the patients with ITP and mechanism of TPO regulation. The relationship between serum TPO levels and the treatment response will also be studyied.Methods: Patients : 69 children with ITP presentinting at thechildren's hospital during in Jan 2001-Oct 2001 were studied. 59 patients with AITP were one month to eleven years old. 10 patients with CITP were three years to eleven years old. 31 normal subjects were one month to eleven years old. Platelet counts were performed on and Sysemex KX-21 automated Complete blood counter. Megakaryocytses in bone morrow were counted manually. The serum TPO levels were measured by sandwich- ELISA method. After treatment, the serum levels of TPOand platelet counts were measured too in 35 of children with TTP. All results were presented as the mean ± standard deviation (SD). T test and correlation analyses were performed using statistical software program and artifical calculated. P<0.05 was considered satistically significant.Results: The platelet counts were 16.52 ± 10.55 × 109/L in 69 children with ITP, 16.22±10.24 × 109/L in 59 children with AITP,19.30 ±12.03 × 109/L in 10 children with CITP. The platelet counts were significant lower in patients than the normal subjects (P<0.05). Megakaryocyte numbers were 272.89 ± 231.24 in 69 children withITP ,270.75±229.29 in 59 children with AITP,287.00±259.86 in 10children with CITP. The number of megakaryocytes was significant higher than the normal subjects (P<0.05).The serum levels of TPO were 213.82±122.61pg/ml in 69 children with ITP . There is no significant increase of TPO in children with ITP compared with that of in 31 normalsubjects (229.34±134.52pg/ml,P>0.05) .The serum levels of TPO were 221.171127.10 pg/ml in AITP, and 170.75±84.14 pg/ml in CITP. There isno significant difference between the two group (P > 0.05) . The pre-treatment and post-treatment serum TPO levels were 206.09±129.49 pg/ml, 161.60±131.61pg/ml respectively. Post-treatment serum TPOlevels were significant lower than that of pre-treatment (P<0.05) .Pre-treatment serum TPO levels were 184.25 ±71.70pg/ml , 222.26±159.91 pg/ml respectivly in steriod ±IVIG group and steroid group.Post-treatment the serum TPO levels were 154.25±80.95 pg/ml,167.11±161.53 pg/ml respectivly in steriod ±IVIG group and steroid group .The serum TPO levels were no difference between the two group Pre-treatment and Post-treatment . The serum TPO levels were 188.76±67.36 pg/ml in ITP with poor response to treatment, and were 218.57 ±133.31 pg/ml in ITP with good response to treatment. The correlation was -0.24 between serum TPO levels and platelet, -0.13 between serum TPO levels and megkaryocyte. The correlation of serum TPO levels and platelet between the pre-treatment and post-treatment were -0.01 and 0.07 respectively.The serum TPO levels have not correlation with platelet and megkaryocyte.Conclusion: The serum TPO levels were normal in children with ITP.The Serum TPO levels were no difference in between AITP and CITP. Serum TPO was regulated not only by platelet but also by megakaryocyte. Relative deficiency of endogenous TPO could be exist,it could play a role in the pathophsiology of thrombocytopenia in ITP.The serum levels of TPO may not be influenced by different treatment regiem.
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