Abstract:

Objective To explore the role of bone marrow TPO and its receptor c⁃Mpl in the diagnosis pri⁃ mary immune thrombocytopenia（ITP），study their correlation with curative effects，and explore the factors influ⁃ encing the therapeutic effect of glucocorticoid. Methods The total number of megakaryocytes，the number of thro⁃ mocytogenic megakaryocytes and the ratio of them in the bone marrows of 50 ITP patients（ITP group），20 hyper⁃ splenism patients（hypertension group）and 16 MDS patients（MDS group）were compared. ABC⁃ELISA and flow cytometry were used to detect the TPO level and expression level of c⁃Mpl in the bone marrows. The data were ana⁃ lyzed by SPSS 19.0. Results The total numbers of megakaryocytes and the thromocytogenic megakaryocytes in the ITP group were significantly larger than those in the MDS group and the hypersplenism group，but the number of megakaryocytes in the ITP group was significantly smaller than those in the MDS group（P < 0.05）and howev⁃ er，the levels of TPO and c⁃Mpl were significantly lower than MDS and hypersplenism（P < 0.05）. The levels of TPO and c⁃Mpl were significantly higher in PLT < 30 × 109 /L ITP sub⁃group than in PLT ≥ 30 × 109 /L ITP sub⁃ group（P < 0.05）. The analysis of the effective group and the ineffective group among the ITP patients showed that the shorter the treatment response time was，the lower the ratio of labor to macrosomia，the higher the bleeding score and the better the treatment response. Conclusion TPO and c⁃Mpl can be used as the indicators for the dif⁃ ferential diagnosis of ITP，MDS and hypersplenism. In the course of ITP treatment，the response time，the ratio of thromocytogenic megakaryocyte to total megakaryocytes and the bleeding score are helpful for investigating the prog⁃ nosis of treatment response，but more case data are needed for further discussion.

Key words:

thrombocytopenia, primary, immunity, thrombopoietin, receptor, c?mpl