Khảo sát giá trị tiểu cầu lưới trên bệnh nhân giảm tiểu cầu tại bệnh viện Chợ Rẫy=Survey the value of reticulated platelet in thrombocytopenia patients at Cho Ray hospital

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Tác giả: Thị Trang Cao, Dương Bích Trâm Huỳnh, Phước Lợi Lê, Văn Được Lê, La Thủy Tiên Nguyễn, Thị Thảo Nguyễn, Thị Thoa Nguyễn, Thị Kim Vân Phạm, Châu Tài Quách, Thanh Tùng Trần, Ngọc Quyên Trương

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.493-500

Bộ sưu tập: Báo, Tạp chí

ID: 478315

Thêm vào giỏ

The patients were examined and treated at Cho Ray Hospital from July 2023 to May 2024, that included 112 control patients with normal platelet counts and 291 thrombocytopenic patients with platelet counts <
150 G/L. Additionally, 90 healthy individuals underwent routine health check-ups. The RtcPLT% test was analyzed using the Siemens Advia 2120i automatic hematology analyzer by reticulocyte channel. Bone marrow results and electronic medical records were utilized to classify the causes. The mean and median values of RtcPLT% were analyzed between the study groups. Research Method: Cross-sectional study. Result: We recorded a total of 493 samples, with the median RtcPLT% as follows: 90 healthy individuals had a median RtcPLT% of 1.58 [1.14 - 2.37], 112 control group samples had a median RtcPLT% of 1.74 [1.29 - 2.86], and 291 thrombocytopenic group samples had a median RtcPLT% of 3.49 [1.51 - 6.88]. Within the thrombocytopenic group, the median RtcPLT% results were further categorized as follows: 216 sample with bone marrow causes had a median of 2.29[1.15- 3.86], 163 samples with bone marrow pathology had a median of 1.97 [1.02 - 3.46], 53 samples with myelodysplasia had a median of 4.16 [2.14 - 7.14], and 75 samples with peripheral causes had a median of 8.27 [6.03 - 11.06]. The differences in RtcPLT% values between the control group and the thrombocytopenic group, as well as among the three subgroups of causes, were statistically significant. Conclusion: RtcPLT% values can be used to support differentiate the diagnosis cause between bone marrow with peripheral and furthermore is differentiate the three groups cause in the marrow - peripheral – myelodysplasia.Tiểu cầu lưới (TCL) RtcPLT% là tiểu cầu vừa được giải phóng ra khỏi mẫu tiểu cầu trong tủy xương ra máu ngoại vi, có kích thước lớn và chứa nhiều RNA hơn tiểu cầu trưởng thành. TCL có thể phản ánh quá trình sinh tiểu cầu của tủy xương, do đó ở những bệnh nhân giảm tiểu cầu với nguyên nhân khác nhau thì giá trị RtcPLT% cũng có sự thay đổi khác nhau. Đối tượng nghiên cứu: Bệnh nhân đi khám bệnh và điều trị tại Bệnh viện Chợ Rẫy (BVCR) từ tháng 7/2023–05/2024, trong đó có 112 bệnh nhân (BN) nhóm chứng có số lượng tiểu cầu (SLTC) bình thường và 291 BN giảm tiểu cầu có SLTC <
150 G/L. Ngoài ra 90 nhân viên khỏe mạnh khám sức khỏe định kỳ cũng đưa vào nghiên cứu. Xét nghiệm RtcPLT% được phân tích trên máy huyết học tự động Siemens Advia 2120i trên kênh đo hồng cầu lưới, sử dụng kết quả huyết tủy đồ và bệnh án điện tử phân nhóm nguyên nhân. Phân tích giá trị trung bình và trung vị của RtcPLT% giữa các nhóm nghiên cứu. Phương pháp nghiên cứu: Cắt ngang mô tả Kết quả: Nghiên cứu chúng tôi ghi nhận tổng cộng 493 mẫu, có kết quả trung vị RtcPLT% như sau: 90 người nhóm khỏe mạnh là 1,58 [1,14 – 2,37], 112 mẫu cho nhóm chứng 1,74 [1,29 – 2,86] và 291 mẫu nhóm giảm tiểu cầu (GTC) 3,49 [1,51–6,88]. Kết quả trung vị RtcPLT% cho những nhóm nguyên nhân GTC gồm 216 nguyên nhân tại tủy NNTT 2,29[1,15- 3,86] trong đó 163 mẫu có nguyên nhân bệnh lý tại tủy (BLTT) là 1,97 [1,02 – 3,46], 53 mẫu loạn sinh tủy (LST) là 4,16 [2,14 – 7,14] và 75 mẫu cho nguyên nhân ngoại biên (NNNB) 8,27 [6,03 – 11,06]. Sự khác biệt giá trị TCL giữa các nhóm chứng và giảm tiểu cầu, giữa 3 nhóm nguyên nhân BLTT - LST - NNNB có ý nghĩa thống kê. Kết luận: Giá trị TCL có thể sử dụng để giúp hỗ trợ chẩn đoán phân biệt nguyên nhân ban đầu là tại tủy hay ngoại biên và hơn nữa là giữa 3 nhóm bệnh lý tại tủy - ngoại biên - loạn sinh.

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