A Study On Platelet Indices And Platelet Membrane Glycoprotein In Children Primary Immune Thrombocytopenia

Objective Primary immune thrombocytopenia(ITP) is a common hemorrhage disease in children,The mainly mechanism is due to autoimmune disorder resulting to thrombocytopenia, the clinical feature are the extensive mucocutaneous bleeding.So far,it is still controversial for that ITP is required conventional bone marrow biopsy for diagnose,and little research on the changes of platelet function.The research speculated the platelet functions of state by detecting the change of related parameters and platelet membrane glycoprotein, so as to provide the reason of the diagnosis, disease evaluation and therapeutic effect evaluation for ITP. Method select 18 cases of newly diagnosed ITP patients in the experimental group and the experimental group is divided into ITP group(before treatment) and ITP-CR group(ITP in completely reaction after treatment) and 17 patients undergoing elective surgical procedure(control group)at the same time, The changes of platelet indices、immature platelet fraction(IPF%)、immature platelet counts(IPC)、granule membrane glycoprotein of platelet(CD62p)、PAC-1 and CD42 b were obtained by using automatic blood cell analyzer and whole blood flow cytometry(FCM),Using spss17 software for statistical analysis. Results(1) PLT、PCT in ITP decreased than that in ITP-CR and control group(P﹤0.05),MPV、PDW、P-LCR in ITP increased than that in ITP-CR and control group(P﹤0.05),while ITP-CR compare with control group,there was no significant difference between ITP-CR and control group about MPV、PDW、PCT、P-LCR(P>0.05), PLT is reduced(P﹤0.05).(2)IPF% in ITP increased than that in ITP-CR and control group(P﹤0.05),IPC in ITP decreased than that in ITP-CR and control group(P﹤0.05),while ITP-CR compare with control group,IPF% increased(P﹤0.05), IPC decreased,but there was no significant difference(P>0.05)。(3)Without addition of platelet agonists ADP, The expression of platelet surface activated CD62p、PAC-1 and CD42 b in ITP decreased than that in ITP-CR and control group(P﹤0.05);while ITP-CR compare with control group, The expression of platelet surface activated PAC-1 decreased(P ﹤ 0.05); there was no significant difference about the expression of platelet surface activated CD62 p and CD42b(P>0.05);With addition of platelet agonists ADP,The expression of platelet surface activated CD62p、PAC-1 and CD42 b in ITP decreased than that in control group and ITP-CR(P﹤0.05);while ITP-CR compare with control group,The expression of platelet surface activated PAC-1 decreased(P ﹤ 0.05), The expression of platelet surface activated CD62 P increased(P﹤0.05),there was no significant difference about the expression of platelet surface activated CD42b(P>0.05).(4) Without addition of agonists ADP,The expression of average fluorescence intensity of PAC-1 and CD42 b in ITP decreased than that in ITP-CR and control group(P﹤0.05),there was no significant difference between ITP-CR and control group about the expression of average fluorescence intensity of PAC-1、CD42b(P>0.05),there was no significant difference between the three group about The expression of average fluorescence intensity of CD62P( P >0.05),With addition of ADP, the expression of average fluorescence intensity of CD62p、PAC-1 and CD42 b in ITP decreased than that in ITP-CR and control group(P﹤0.05),while ITP-CR compare with control group,the expression of average fluorescence intensity of CD62 P in ITP-CR increased(P﹤0.05),there was no significant difference about The expression of average fluorescence intensity of PAC-1 and CD42b(P>0.05).(5)Conclusion In newly diagnosed childhood ITP, the platelets are lower activation state in vivo and in vitro, the platelet function is abnormal,it suggest that the reason of hemorrhage in ITP is not noly the decrease of the platelet count,But Also the depression of platelet function. It can be used as effective indicators to judge the effect of ITP for the platelet indices and platelet membrane glycoprotein.