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目的探讨急性肺血栓栓塞症(PTE)患者溶栓治疗时血小板参数的变化趋势及临床意义。方法选取本院收治的38例急性肺血栓栓塞症患者,应用Sysmex XE-5000全自动血液分析仪检测患者在溶栓治疗前、溶栓治疗后1周的静脉血血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)及大血小板比率(P-LCR),与100例健康成人所测结果进行比较分析。并比较分析其中12例PTE患者治疗后1周、2周及4周的血小板参数。结果 PTE患者溶栓治疗前血小板计数与正常对照组比较差异有统计学意义(P<0.05),而血小板平均体积、血小板分布宽度及大血小板比率与健康对照组比较差异无统计学意义(P>0.05);溶栓治疗后1周,血小板计数高于溶栓治疗前,血小板分布宽度及大血小板比率低于溶栓治疗前,两者比较差异均有统计学意义(P<0.05),而血小板平均体积与溶栓治疗前比较差异无统计学意义(P>0.05)。12例PTE患者在溶栓治疗后2周、4周的血小板平均体积与溶栓治疗前比较差异有统计学意义(P<0.05)。结论急性肺血栓栓塞症发生和溶栓治疗时血小板参数会发生改变,监测PTE患者血小板参数的相关变化,对PTE诊断治疗有重要的临床意义。
Objective To investigate the change trend and clinical significance of platelet parameters in thrombolytic therapy in patients with acute pulmonary thromboembolism (PTE). Methods Thirty-eight patients with acute pulmonary thromboembolism admitted to our hospital were enrolled in this study. Before and after thrombolytic therapy, the venous blood platelet count (PLT), platelet count Volume (MPV), platelet distribution width (PDW), and large platelet ratio (P-LCR) were compared with those measured in 100 healthy adults. The platelet parameters of 12 patients with PTE at 1 week, 2 weeks and 4 weeks after treatment were compared and analyzed. Results The platelet count of patients with PTE before thrombolysis was significantly lower than that of the normal control group (P <0.05), while the mean platelet volume, the distribution width of platelets and the ratio of large platelet were not significantly different from those of healthy controls (P> 0.05). One week after thrombolysis, the platelet count was higher than that before thrombolysis, the distribution width of platelets and the ratio of large platelets were lower than those before thrombolytic therapy (P <0.05), while the mean platelet volume There was no significant difference between before and after thrombolytic therapy (P> 0.05). The average volume of platelets in 12 patients with PTE at 2 weeks and 4 weeks after thrombolytic therapy was significantly lower than that before thrombolysis (P <0.05). Conclusions Acute pulmonary thromboembolism may result in changes in platelet parameters during thrombolytic therapy. Monitoring changes in platelet parameters in patients with PTE may have important clinical implications for the diagnosis and treatment of PTE.