Aetiology and clinical significance of thrombocytosis: analysis of 732 patients with an elevated platelet count
Aetiology and clinical significance of thrombocytosis: analysis of 732 patients with an elevated platelet count
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DOI：
10.1046/j.1365-2796.1999.00452.x
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发表时间：
1999-03-01
影响因子：
11.1
通讯作者：
Heimpel, H
中科院分区：
文献类型：
--
作者：
Griesshammer, M;Bangerter, M;Heimpel, H
Objective.在一个大的患者队列中确定血小板计数升高（血小板增多症）的病因和临床意义。对所有患者的病历进行回顾性审查，这些患者至少有一次血小板计数大于或等于500 x 10（9）L-1设置。德国乌尔姆大学内外科，受试者，共732例血小板增多症患者。主要结果测量。血小板增多症和血栓栓塞并发症的分类，以及区分原发性和继发性血小板增多症的实验室参数的评价，结果。原发性血小板增多症89例（12.3%），继发性血小板增多症643例（87.7%），原发性血小板增多症40例（45%）。继发性血小板增多症最常见的原因是组织损伤（42%）、感染（24%）、恶性肿瘤（13%）和慢性炎症（10%）。原发性血小板增多症与血小板计数升高以及动脉和静脉血栓栓塞并发症的发生率增加显著相关。血栓栓塞事件仅限于静脉系统，并且仅在存在其他风险因素的情况下发生。原发性血小板增多症与继发性血小板增多症的白细胞计数、红细胞压积、血沉、纤维蛋白原、血钾、乳酸脱氢酶的平均值有显著性差异。在常规血液检查中发现血小板计数升高具有诊断、预后和治疗意义。区分原发性和继发性血小板增多症具有重要的临床意义，因为血栓性并发症在原发性血小板增多症中更常见。除非存在其他风险因素，否则继发性血小板增多与血栓栓塞事件的显著风险无关。
Objective. To determine the aetiology and clinical significance of an elevated platelet count (thrombocytosis) in a large cohort of patients.Design. A retrospective review of the medical records was performed on all patients, who had at least, one platelet count greater than or equal to 500 x 10(9) L-1Setting. Departments of Medicine and Surgery, University of Ulm, Germany,Subjects, A total of 732 patients with thrombocytosis.Main outcome measures. Classification of thrombocytosis and thromboembolic complications, and evaluation of laboratory parameters distinguishing between primary and secondary thrombocytosis,Results. Of the total of 732 patients, 89 (12.3%) had primary and 643 (87.7%) had secondary thrombocytosis, Essential thrombocythaemia was observed in 40 of 89 patients (45%) with primary thrombocytosis. The most frequent causes of secondary thrombocytosis were tissue damage (42%), infection (24%), malignancy (13%) and chronic inflammation (10%), Primary thrombocytosis was significantly associated with a higher platelet count and an increased incidence of both arterial and venous thromboembolic complications, In secondary thrombocytosis, thromboembolic events were restricted to the venous system and occurred only in the presence of other risk factors. Mean values of leucocyte count, haematocrit, erythrocyte sedimentation rate, fibrinogen, serum potassium and lactate dehydrogenase were significantly different in primary and secondary thrombocytosis.Conclusions. The finding of an elevated platelet count on routine blood examination has diagnostic, prognostic and therapeutic implications. It is of clinical importance to distinguish between primary and secondary thrombocytosis, as thrombotic complications occur more frequently in primary thrombocytosis. Unless additional risk factors are present, secondary thrombocytosis is not associated with a significant risk for thromboembolic events.