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目的探讨儿童急性淋巴细胞白血病(ALL)时血小板活化状态及功能的变化。方法研究对象均来自西南医科大学附属医院2012年6月至2013年11月收治的住院患儿,应用全自动血细胞分析仪和流式细胞术(FCM)微量全血法检测ALL患儿(ALL组)、ALL诱导缓解治疗达完全缓解患儿(ALL-CR1组)以及外科择期手术患儿(正常组)的血小板参数、网织血小板百分率(IPF%)、网织血小板绝对值(IPC)、颗粒膜糖蛋白(CD62p)、PAC-1。结果二磷酸腺苷(ADP)激活前,ALL组CD62p、PAC-1表达高于正常组(P<0.05),ALL-CR1组PAC-1表达高于正常组(P<0.05),低于ALL组(P<0.05);ADP激活后,ALL组CD62p、PAC-1表达低于正常组(P<0.05),ALL-CR1组PAC-1表达低于正常组(P<0.05),高于ALL组(P<0.05);ALL组血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)均低于正常组和ALL-CR1组(P<0.05);ALL组IPF%高于正常组和ALL-CR1组(P<0.05),IPC低于正常组和ALL-CR1组(P<0.05)。结论ALL初诊患儿存在血小板活化,同时伴有血小板功能异常。血小板参数及血小板膜糖蛋白可作为判断ALL疗效的有效指标。
Objective To investigate the changes of platelet activation status and function in childhood acute lymphoblastic leukemia (ALL). Methods The subjects were all from hospitalized patients who were admitted to Affiliated Hospital of Southwest Medical University from June 2012 to November 2013. ALL patients (ALL group) were detected by automatic hematology analyzer and flow cytometry (FCM) ), Platelet parameters (IPF%), reticulated platelet absolute value (IPC), granule size in ALL-CR1 group, and children undergoing elective surgery (normal group) Membrane glycoprotein (CD62p), PAC-1. Results Before the activation of ADP, the expression of CD62p and PAC-1 in ALL group was higher than that in normal group (P <0.05). The expression of PAC-1 in ALL-CR1 group was higher than that in normal group (P <0.05) (P <0.05). After ADP activation, the expression of CD62p and PAC-1 in ALL group was lower than that in normal group (P <0.05). The expression of PAC-1 in ALL-CR1 group was lower than that in normal group (P <0.05). The PLT, PCT and MPV in ALL group were lower than those in normal group and ALL-CR1 group (P <0.05) The normal group and ALL-CR1 group (P <0.05), IPC lower than the normal group and ALL-CR1 group (P <0.05). Conclusion The newly diagnosed children with ALL have platelet activation and platelet dysfunction. Platelet parameters and platelet membrane glycoprotein can be used as effective indicators to determine the efficacy of ALL.