中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (5): 796-799.doi: 10.3969/j.issn.1673-8225.2011.05.009

• 肝移植 liver transplantation • 上一篇    下一篇

网织红细胞及血小板参数在原位肝移植Child-Pugh分级患者围手术期的变化

崔娟红1，陈  晖2，孙  涛1，王峥辉1，郭晓今1，宋丽洁1   

  1. 武装警察部队总医院，1检验科，  2麻醉科，北京市   100039
  • 收稿日期:2010-07-25 修回日期:2010-08-28 出版日期:2011-01-29 发布日期:2011-01-29
  • 通讯作者: 宋丽洁，硕士，副主任技师，武装警察部队总医院检验科，北京市 100039 sljdhl@sina.com
  • 作者简介:崔娟红，女，1973年生，陕西省西安市人，汉族，2009年天津医学院毕业，主治医师，主要从事细胞形态学、临床检验学研究。 wangxu7082@163.com

Changes of reticulocyte and platelet parameters at perioperative stage of Child-Pugh grading patients after orthotopic liver transplantation 

Cui Juan-hong1, Chen Hui2, Sun Tao1, Wang Zheng-hui1, Guo Xiao-jin1, Song Li-jie1   

  1. 1Department of Clinic Laboratory, 2Department of Anesthesiology, General Hospital of Chinese People’s Armed Police Forces, Beijing  100039, China
  • Received:2010-07-25 Revised:2010-08-28 Online:2011-01-29 Published:2011-01-29
  • Contact: Song Li-jie, Master, Associate chief technician, Department of Clinic Laboratory, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China sljdhl@sina.com
  • About author:Cui Juan-hong, Attending physician, Department of Clinic Laboratory, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China wangxu7082@163.com

PDF

381

被引次数

3

摘要：

背景：临床医生常通过观察白细胞、血红蛋白、血小板等指标来了解肝移植后患者的恢复情况，而较少采用网织红细胞、平均血小板体积等指标进行评估。
目的：观察原位肝移植Child-Pugh分级患者围手术期及恢复期网织红细胞百分比、网织红细胞未成熟指数、血小板计数、平均血小板体积的动态变化规律，并分析其与Child-Pugh分级的关系。
方法：根据Child-Pugh评分将129例终末期肝病患者分为3组，Child-Pugh5~6分组44例，Child-Pugh7~9分组48例，Child-Pugh10~15分组37例。于肝移植前及移植后第1，3，5，7，10，15，30天抽取静脉血，采用全自动血液分析仪(SysmexXE-2100)测定网织红细胞百分比、网织红细胞未成熟指数、血小板计数、平均血小板体积，并与正常对照组进行对比分析。
结果与结论：3组患者肝移植前网织红细胞百分比、网织红细胞未成熟指数均高于正常值，且随着Child评分的增加而增高。移植后网织红细胞百分比先下降后上升再下降，网织红细胞未成熟指数在移植后呈上升趋势，均在第7天达到峰值后下降。血小板计数和Child-Pugh分级有关，病情越重，血小板计数越低，平均血小板体积越大。Child-Pugh5~6分组、Child-Pugh7~9分组、Child-Pugh 10~15分组移植后血小板计数经历一个低值阶段后逐渐回升。提示网织红细胞及血小板相关参数的测定是判断肝移植Child-Pugh分级患者移植后疗效以及预测其骨髓功能是否受抑的重要实验指标。

关键词: 网织红细胞, 肝移植, Child-Pugh分级, 网织红细胞未成熟指数, 血小板, 平均血小板体积

Abstract:

BACKGROUND: Results of white blood cell WBC, hemoglobin, and platelet, rather than reticulocyte (RET) or mean platelet volume (MPV) are observed to study the recovery of patients after liver transplantation. 
OBJECTIVE: To explore change laws of RET, immature reticulocyte fraction (IRF), blood platelets count (BPC), and MPV in Child-Pugh grading patients with orthotopic liver transplantation during perioperative stage and the recovery period, and to analyze the relationship to Child-Pugh classification.
METHODS: Totally 129 cases with end-stage liver diseases were divided into Child-Pugh 5-6 score group (n=44), Child-Pugh 7-9 score group (n=48) and Child-Pugh 10-15 score group (n=37). All the samples were obtained at preoperative stage and at 1, 3, 5, 7, 10, 15 and 30 days after transplantation. The RET, IRF, BPC and MPV were measured by Sysmex XE-2100 hematology analyzer and compared with control group.
RESULTS AND CONCLUSION: It showed that RET% and IRF in patients at preoperative stage was significantly higher in the case groups than that of control group, which increased with Child integrate raises. The RET% was increased and then decreased, but IRF increased after transplantation, both of them reached a peak at 7 days after transplantation. It observed that BPC was related to Child-pugh classification, the serious pathogenetic condition lead to low BPC and larger MPV. The BPC was gradually increased from the Child-Pugh 5-6 score group to Child-Pugh 10-15 score group after experiencing a period of low value after transplantation. The findings demonstrated that RET and platelet indicators have an important reference value for judging therapeutic effect in Child-Pugh grading patients and predicting bone marrow functions after liver transplantation.

中图分类号: