Sysmex XN血液分析仪未成熟血小板比率在血小板减少性疾病中的应用
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摘要
目的评估Sysmex XN血液分析仪未成熟血小板比率(IPF%)在血小板减少性疾病中的应用。方法选取血小板减少性疾病患者200例[原发免疫性血小板减少症(ITP组)患者45例、再生障碍性贫血(AA组)患者40例、化疗患者(CT组)60例、慢性肝病(CLD组)患者55例]以及体检健康者(健康对照组)50名,采用Sysmex XN血液分析仪检测其外周血血小板(PLT)及IPF%,用Graph Pad Prism 6软件比较各疾病组与健康对照组之间IPF%差异,采用受试者工作特征(ROC)曲线分析IPF%在各组疾病中的诊断价值。结果 ITP组、AA组、CT组及CLD组PLT计数均显著低于健康对照组(P<0.05),而ITP组与AA组间以及CT组与CLD组间PLT计数差异无统计学意义(P>0.05)。ITP组IPF%显著高于健康对照组、AA组、CT组及CLD组(P<0.05),而AA组、CT组、CLD组及健康对照组之间IPF%差异均无统计学意义(P>0.05)。当IPF%临界值为5.8%时,其鉴别诊断ITP与低增生性PLT减少症的敏感性和特异性分别为82.2%和86.8%,曲线下面积(AUC)为0.92。结论 Sysmex XN血液分析仪IPF%参数在鉴别高增生性及低增生性PLT减少症中有一定应用价值。
Objective To evaluate the role of immature platelet fraction(IPF%) determination by Sysmex XN automated hematology analyzer for thrombocytopenia. Methods The platelet(PLT) counts and IPF% of200 patients with thrombocytopenia [45 patients with primary immune thrombocytopenia(ITP),40 patients with aplastic anemia(AA),60 patients undergoing chemotherapy(CT) and 55 patients with chronic liver diseases(CLD)] and 50 healthy subjects(healthy control group) were determined by Sysmex XN automated hematology analyzer. The difference of IPF% was analyzed by GraphPad Prism 6 software,and receiver operating characteristic(ROC) curve analysis was utilized to demonstrate the diagnostic ef?ciency of IPF% in the assessment of thrombocytopenia. Results The PLT counts of ITP,AA,CT and CLD groups were lower than that of healthy control group(P<0.05). However,there was no statistical signi?cance between ITP and AA groups and between CT and CLD groups(P>0.05). IPF% of ITP group was higher than those of healthy control,AA,CT and CLD groups(P<0.05),while there was no statistical signi?cance between AA,CT and CLD groups and healthy control group(P>0.05). When the cut-off value of IPF% was 5.8%,the sensitivity was 82.2%,the speci?city was 86.8%,and the area under curve(AUC) was 0.92. Conclusions IPF% determination by Sysmex XN automated hematology analyzer plays a role for discriminating hypo-from hyper-proliferative thrombocytopenias.
Objective To evaluate the role of immature platelet fraction(IPF%) determination by Sysmex XN automated hematology analyzer for thrombocytopenia. Methods The platelet(PLT) counts and IPF% of200 patients with thrombocytopenia [45 patients with primary immune thrombocytopenia(ITP),40 patients with aplastic anemia(AA),60 patients undergoing chemotherapy(CT) and 55 patients with chronic liver diseases(CLD)] and 50 healthy subjects(healthy control group) were determined by Sysmex XN automated hematology analyzer. The difference of IPF% was analyzed by GraphPad Prism 6 software,and receiver operating characteristic(ROC) curve analysis was utilized to demonstrate the diagnostic ef?ciency of IPF% in the assessment of thrombocytopenia. Results The PLT counts of ITP,AA,CT and CLD groups were lower than that of healthy control group(P<0.05). However,there was no statistical signi?cance between ITP and AA groups and between CT and CLD groups(P>0.05). IPF% of ITP group was higher than those of healthy control,AA,CT and CLD groups(P<0.05),while there was no statistical signi?cance between AA,CT and CLD groups and healthy control group(P>0.05). When the cut-off value of IPF% was 5.8%,the sensitivity was 82.2%,the speci?city was 86.8%,and the area under curve(AUC) was 0.92. Conclusions IPF% determination by Sysmex XN automated hematology analyzer plays a role for discriminating hypo-from hyper-proliferative thrombocytopenias.
引文
[1]PONS I,MONTEAGUDOM,LUCCHETTIG,et al.Correlation between immature platelet fraction and reticulated platelets.Usefulness in the etiology diagnosis of thrombocytopenia[J].Eur J Haematol,2010,85(2):158-163.
[2]SAKURAGI M,HAYASHI S,MARUYAMA M,et al.Clinical significance of IPF%or RP%measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders[J].Int J Hematol,2015,101(4):369-375.
[3]夏永辉,李筱梅,李勇,等.IPF相关参数参考范围调查及其在血小板减少性疾病诊断中的探讨[J].检验医学,2012,27(9):745-748.
[4]蒋伟燕,江明华,吴义忠,等.未成熟血小板分数在血小板减少性疾病中的变化[J].检验医学,2013,28(1):47-50.
[5]任春云,武锦彪,郭希超.血液分析仪检测网织血小板比率在血小板减少性疾病中的应用[J].临床检验杂志,2010,28(5):343-344.
[6]CYBULSKA A,MEINTKER L,RINGWALD J,et al.Measurements of immature platelets with haematology analysers are of limited value to separate immune thrombocytopenia from bone marrow failure[J].Br JHaematol,2017,177(4):612-619.
[7]IMPERIALI C E,ARBIOL-ROCA A,SANCHEZ-NAVARRO L,et al.Reference interval for immature platelet fraction on Sysmex XN haematology analyser in adult population[J].Biochem Med(Zagreb),2018,28(1):010708.
[8]MIYAZAKI K,KOIKE Y,KUNISHIMA S,et al.Immature platelet fraction measurement is influenced by platelet size and is a useful parameter for discrimination of macrothrombocytopenia[J].Hematology,2015,20(10):587-592.
[2]SAKURAGI M,HAYASHI S,MARUYAMA M,et al.Clinical significance of IPF%or RP%measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders[J].Int J Hematol,2015,101(4):369-375.
[3]夏永辉,李筱梅,李勇,等.IPF相关参数参考范围调查及其在血小板减少性疾病诊断中的探讨[J].检验医学,2012,27(9):745-748.
[4]蒋伟燕,江明华,吴义忠,等.未成熟血小板分数在血小板减少性疾病中的变化[J].检验医学,2013,28(1):47-50.
[5]任春云,武锦彪,郭希超.血液分析仪检测网织血小板比率在血小板减少性疾病中的应用[J].临床检验杂志,2010,28(5):343-344.
[6]CYBULSKA A,MEINTKER L,RINGWALD J,et al.Measurements of immature platelets with haematology analysers are of limited value to separate immune thrombocytopenia from bone marrow failure[J].Br JHaematol,2017,177(4):612-619.
[7]IMPERIALI C E,ARBIOL-ROCA A,SANCHEZ-NAVARRO L,et al.Reference interval for immature platelet fraction on Sysmex XN haematology analyser in adult population[J].Biochem Med(Zagreb),2018,28(1):010708.
[8]MIYAZAKI K,KOIKE Y,KUNISHIMA S,et al.Immature platelet fraction measurement is influenced by platelet size and is a useful parameter for discrimination of macrothrombocytopenia[J].Hematology,2015,20(10):587-592.