High platelet count means high platelets, the most typical of which is thrombocytosis. The obvious feature of this disease is repeated bleeding. The incidence rate is not very high and is mainly concentrated in the age group over 40 years old. There are many reasons for high platelets, and understanding these factors will help us better prevent and respond. So, what is the reason for the high blood sugar level? Let’s take a closer look below. Thrombocytosis is a myeloproliferative disease characterized by bleeding tendency and thrombosis, a persistent and significant increase in peripheral blood platelets, abnormal function, and excessive proliferation of bone marrow megakaryocytes. Because this disease often causes repeated bleeding, it is also called hemorrhagic thrombocythemia. The incidence rate is not high and is more common in people over 40 years old. The clinical manifestations have a slow onset and vary in severity. About 20% of patients, especially young people, have no symptoms at onset and are occasionally diagnosed through blood tests or the discovery of splenomegaly. In mild cases, there are only dizziness and fatigue; in severe cases, there may be bleeding and thrombosis. Bleeding is often spontaneous and may recur, occurring in about 2/3 of patients. Gastrointestinal bleeding is common, and there may also be epistaxis, gingival bleeding, hematuria, and ecchymosis of the skin and mucous membranes, but purpura is rare. The incidence of thrombosis is less than that of bleeding. According to domestic statistics, 30% of patients suffer from arterial or venous thrombosis. After limb vascular embolism, limb numbness, pain, and even gangrene may occur, and erythromelalgia may also occur. Thrombosis of the spleen and mesenteric vessels can cause abdominal pain and vomiting. Pulmonary, cerebral, and renal embolism cause corresponding clinical symptoms. Splenomegaly accounts for 80% and is generally mild to moderate. A few patients have hepatomegaly. Essential thrombocythaemia should be differentiated from other myeloproliferative disorders characterized by elevated platelet counts. The key points of diagnosis should include: normal red blood cell count (increased in polycythemia vera), absence of Ph chromosome (may be present in chronic myeloid leukemia), absence of teardrop-shaped red blood cells and a large increase in bone marrow fibrosis (seen in idiopathic myelofibrosis). Although the platelet count can be as low as 500,000/μl, it is usually >1X106/μl. In the peripheral blood smear, platelet aggregates, giant platelets and megakaryocyte fragments may be found. Megakaryocytes in the bone marrow proliferate and release large numbers of platelets. Bone marrow iron is usually present. Treatment methods Western medicine treatment Although most experts believe that when the patient's platelet count exceeds 1X106/μl and there are bleeding or embolic complications, treatment should be given. However, the indications for the treatment of essential thrombocythemia are still unclear. The goal of treatment is to reduce platelet count to normal or near normal to prevent thrombosis and bleeding. ① The bone marrow suppressive drug busulfan is a commonly used and effective drug, and it is advisable to use a small dose, starting with 4-6 mg/d. If a rapid decrease in platelets is required, hydroxyurea 2-4 g/d can be used, and then reduced to 1 g/d after 3-4 days. Cyclophosphamide, chlorambucil, melphalan, etc. are all effective. The medication can be stopped when the platelet count decreases or symptoms are relieved. If there is a relapse, the medication can be used again. ② Radionuclide phosphorus (32P) is taken orally or intravenously with the first dose of 0.08-0.11MBq. If necessary, another dose may be given three months later. It is generally not recommended because of the possibility of inducing leukemia. ③ Platelet separation can quickly reduce the number of platelets and improve symptoms. It is commonly used in gastrointestinal bleeding, pregnancy and delivery, and before elective surgery. ④Interferon Recently, some people have proposed the use of α-interferon to treat essential thrombocythemia. It can inhibit megakaryocyte production and shorten platelet survival. The dosage is 3--5mu/d. |
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