The Correlation Between Platelet Parameters And Bone Marrow Images In Children With ITP And Its Clinical Significance

Objective Discussing the correlation between platelet parameters and bone marrow image in children with immune thrombocytopenia(ITP)and its clinical significance,to provide a theoretical basis for clinical diagnoses and treatment.Methods Retrospectively analyzing the children with ITP who admitted to the pediatrics department of first affiliated hospital,school of medicine,shihezi university from September 2013 to September 2018,117 of them,meeting the standards,are taken as the experimental group.Meanwhile,117 healthy children at the same age and period who came to the clinic department of pediatrics in our hospital for physical examination are selected as the control group.Comparing the indexes,including platelet(PLT),mean platelet volume(MPV),platelet hematocrit(PCT),platelet distribution width(PDW)etc.,of the experimental group before treatment and after treatment,the statistics are analyzed referring to the corresponding indicators of the control group to discuss their clinical significance.45 samples from the experimental group have completed bone marrow aspiration,so that correlational analyses are conducted between the bone marrow parameters such as megakaryocyte count,proportion of various megakaryocytes and their pre-treatment indexes of PLT,MPV,PCT,PDW.Results(1)Comparison of platelet parameters in the experimental group before treatment and that in the control group: PLT and PCT in the experimental group are lower than those in the control group(P<0.05),PDW is higher than this in control group(P<0.05),MPV is higher than this in control group,but the difference is not statistically significant(P>0.05).(2)Comparison of platelet parameters before and after treatment in the experimental group: PLT and PCT after treatment are higher than that before treatment(P<0.05),MPV after treatment is lower than this before treatment(P<0.05),PDW after treatment is lower than this before treatment,but the difference is not statistically significant(P>0.05).(3)Correlation analysis between platelet parameters before treatment and megakaryocytes in bone marrow image: PLT is positively correlated with thromocytogenic megakaryocytes(r=0.327,P=0.028),MPV is positively correlated with primitive megakaryocytes(r=0.431,P=0.045),PDW is positively correlated with granular megakaryocytes(r=0.528,P=0.014).Conclusion(1)In children with ITP,the PLT and PCT decrease than normal,PDW is higher than normal.After treatment,PLT and PCT increase,MPV decrease.Both the increasing of PLT,PCT and the decreasing of MPV can indicate the effectiveness of treatment.Platelet parameters can be used as an effective indicator for definite diagnoses,efficacy and prognoses of ITP in clinic.(2)PLT,MPV and PDW in peripheral blood are respectively positively correlated with thromocytogenic megakaryocytes,primitive megakaryocytes and granular megakaryocytes in bone marrow.Changes in platelet parameters could be used to evaluate the changes in myeloid megakaryocytes.(3)Dynamic monitoring of platelet parameters plays an importantguiding role in the diagnoses,treatment and prognoses of ITP,which can be further studied and widely used in clinic.