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目的探讨外伤导致原发性血小板增多症与血巨核细胞体外扩散的相关性。方法 2007年9月~2013年12月选择在笔者医院进行急诊的外伤导致原发性血小板增多症患者36例作为观察组,同期选择在笔者医院进行健康体检的健康志愿者36例作为对照组,两组都抽取静脉血进行血浆TPO与IL-11的检测。分离脐带血的单个核细胞,然后与两组的血浆进行共孵育培养,进行CD41a+的表达情况、巨核祖细胞计数和巨核细胞DNA倍体分析。结果观察组在细胞培养10天与15天的巨核细胞数量明显多于对照组。经过巨核系祖细胞集落检测,结果显示观察组的CFU-MK值明显高于对照组(P<0.05)。观察组的血浆TPO和IL-11值明显高于对照组,同时观察组的培养第10天与第15天的多倍体细胞(n≥4)的比例明显高于对照组,对比差异有统计学意义(P<0.05)。结论外伤导致原发性血小板增多症伴随有巨核细胞扩散性与生成增加,是由于血浆中TPO和IL-11过表达增加而导致巨核细胞成熟形成多倍体,使得血小板增多。
Objective To investigate the correlation between trauma-induced thrombocythemia and in vitro proliferation of megakaryocytes. Methods From September 2007 to December 2013, 36 cases of patients with essential thrombocythemia caused by trauma in emergency room at the author’s hospital were selected as the observation group and 36 healthy volunteers who took part in the hospital during the same period were selected as the control group. Both groups were drawn venous blood plasma TPO and IL-11 detection. Umbilical cord blood mononuclear cells were isolated and then co-cultured with the two groups of plasma for expression of CD41a +, megakaryocyte progenitor cell counts, and DNA ploidy analysis of megakaryocytes. Results The number of megakaryocytes in observation group was significantly higher than that of control group on day 10 and day 15 of culture. After megakaryocyte progenitor colony assay, the results showed that the CFU-MK value of the observation group was significantly higher than that of the control group (P <0.05). The plasma TPO and IL-11 levels in the observation group were significantly higher than those in the control group, and the ratio of polyploid cells (n≥4) on day 10 and day 15 of the observation group was significantly higher than that of the control group Significance (P <0.05). Conclusions Traumatic thrombocytopenia leading to increased proliferation and generation of megakaryocytes is due to the overexpression of TPO and IL-11 in the plasma leading to the maturation of megakaryocytes to form polyploidy, resulting in an increase of platelets.