目的 探讨年龄、性别、乙型肝炎病毒(HBV)DNA病毒载量等因素与血小板(PLT)参数之间的关系.方法 对878例乙型肝炎表面抗原(HBsAg)阳性患者的PLT、血小板比容(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、HBV DNA、丙氨酸氨基转移酶/天门冬氨酸氨基转移酶(ALT/AST)等参数进行测定,采用析因设计的方差分析、回归分析、单因素方差分析和两样本t 检验进行统计分析.结果 析因分析证实年龄、性别、HBV DNA会影响PLT相关参数,而ALT/AST则不会.HBsAg阳性人群PLT、PCT比同性别同年龄组的健康人群降低,而MPV和PDW则增大.HBsAg阳性人群高龄组的PLT、PCT与HBV DNA呈负相关,MPV、PDW则无相关关系；其他年龄人群中PLT的4项参数与HBV DNA均无相关关系.结论 高于50岁的HBsAg阳性人群中,PLT和PCT随着HBV DNA载量的增高而降低,可能与HBV DNA载量增加抑制或破坏骨髓巨核细胞分化发育有关.监测该类人群的PLT参数,有利于监控其止凝血问题.%Objective To investigate the relationship between platelet (PLT) parameters and age,sex,hepatitis B virus (HBV) DNA load and other factors. Methods A total of 878 hepatitis B surface antigen (HBsAg) positive patients were enrolled for the determinations of PLT count, thrombocytocrit ( PCT) , mean platelet volume ( MPV) , platelet distribution width (PDW) ,HBV DNA and alanine aminotransferase (ALT)/ aspartate aminotransferase (AST). Variance analysis, regression analysis, one-way ANOVA and 2-sample t-test were used to analyze the data statistically. Results Factorial analysis demonstrated age, sex and HBV DNA would influence PLT parameters, but ALT/AST would not. PLT and PCT were lower in HBsAg positive patients than in healthy subjects with same age and sex,while MPV and PDW were higher. There was a negative relationship of PLT and PCT with HBV DNA in elderly HBsAg positive patients, while MPV and PDW had no correlation. The 4 PLT parameters in young and middle-aged subjects had no correlation with HBV DNA. Conclusions PLT and PCT decrease with the increase of HBV DNA load in HBsAg positive patients over 50 years old, which may be related to the suppression or destruction of megakaryocyte differentiation and growth with the increase of HBV DNA load. Monitoring the PLT parameters is of benefit to monitor the hemostatic and coagulative conditions in the patients.
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