血细胞参数对儿童免疫性血小板减少症和再生障碍性贫血的鉴别诊断意义

Blood cell parameters in differential diagnosis between immune thrombocytopenic purpura and aplastic anemia

关键词:  免疫性血小板减少性紫癜  再生障碍性贫血  鉴别诊断

Key words:  immunologic thrombocytopenic purpura  aplastic anemia  differential diagnosis

摘要:

目的 探讨外周血细胞参数在免疫性血小板减少性紫癜(immune thrombocytopenic purpura, ITP)和再生障碍性贫血(aplastic anemia, AA)鉴别诊断中的意义。方法 分析儿童ITP 36例和AA 40例,运用ROC曲线分析,统计对比儿童ITP和AA的外周血细胞参数在两类疾病鉴别诊断中的意义和价值。结果 除红细胞体积分布宽度及平均血小板体积外,大部分血细胞参数两组间比较差异具有统计学意义(P<0.05)。ROC曲线分析显示红细胞数和白细胞数鉴别两类疾病的曲线下面积分别为0.98和0.95,血小板数鉴别两类疾病的曲线下面积为0.65。除红细胞平均血红蛋白浓度和淋巴细胞计数外,多数血细胞参数鉴别两类疾病的曲线下面积均大于0.8。结论 ITP和AA患儿的外周血细胞参数有各自不同的特点,深入分析外周血细胞参数能很好鉴别ITP和AA,使患者免于创伤性检查。

Abstract:

ObjectiveTo assess the peripheral blood cell parameters in differential diagnosis between immune thrombocytopenic purpura (ITP) and aplastic anemia (AA). Methods The clinical data of 36 ITP patients and 40 AA patients were retrospectively analyzed. Receiver operating characteristic curves(ROC) was used to evaluate peripheral blood cell parameters in differential diagnosis between ITP and AA. Results There were significant differences in blood cell parameters between the two groups(P <0.05), except for red cell volume distribution width and mean platelet volume. ROC analysis showed that the area under curve (AUC) of red blood cells, white blood cells and platelet count in differential diagnosis of ITP and AA were 0.98, 0.95 and 0.65, respectively. The AUCs of most other blood cell parameters were greater than 0.8, except for red blood cells mean hemoglobin concentration and lymphocyte count. Conclusion The peripheral blood cell parameters provide a valuable reference in the differential diagnosis of ITP and AA and the traumatic examination might be avoid with its application.