Recently, many patients have asked whether thrombocytosis is a serious problem, as it is found in routine blood tests. Do I need to see a doctor? What tests should be done? In this regard, the following I will briefly explain the causes of thrombocytosis and targeted diagnosis and treatment, hoping to help the majority of patients. A, primary thrombocytosis (a) clinical manifestations of this type of disease patients are mostly seen in people over 40 years old, manifested as peripheral blood platelets although continued to significantly increase, but the function is not normal, so the main clinical manifestations of such patients are bleeding (nose, oral mucosa, gastrointestinal tract, urinary tract, cerebral hemorrhage, etc.) and thrombosis (more common in elderly patients, cerebral thrombosis, myocardial infarction, pulmonary embolism, thrombosis of the lower extremities, etc.). Physical examination reveals only splenomegaly, usually mild or moderate, in about 40% or more of patients. Splenic atrophy and splenic infarction may occur. Cheng Xue, Department of Hematology, Kailuan General Hospital (II) Examination Bone marrow morphology (bone marrow megakaryocyte hyperplasia predominant, large number of platelet formation), genes, chromosomes and other examinations are clear. (III) Treatment 1. Platelet mono-collection: It is suitable for patients with rapid onset and severe disease, accompanied by embolism or bleeding complications, which can rapidly reduce the amount of platelets and improve the symptoms. 2, myelosuppressive drugs: platelets in the 1000 × 109 / L or more, hydroxy, white elimination, benzodiazepine have a certain hitching effect, about 3 ~ 4 weeks or more to get relief. Platelets can be repeated when they increase again. 3, interferon alpha: can reduce the number of peripheral platelets, improve platelet function, inhibit the malignant clone of bone marrow cells, the efficiency of 70%-80%, but after discontinuation of the drug will relapse as its disadvantage. 4, coagulation and thrombolytic therapy: If there is thrombosis, fibrinolytic activator can be used for thrombolytic therapy. If platelets are significantly increased and there is a high risk of embolism, anti-platelet coagulation drugs such as aspirin and dipyridamole can be given to prevent thrombus formation. (iv) Prognosis The course of the disease varies according to the degree of thrombocytosis. Most cases progress slowly with a median survival of 10 to 15 years. About 25% of patients may turn to myelofibrosis, and some cases may turn to true erythrocytosis or chronic granulocytic leukemia. The combination of important organs with thrombosis and bleeding is often the main cause of death in this disease. Secondary thrombocytosis (a) Etiology: (1) Physiological thrombocytosis: the platelets stored in the spleen and lungs are released when stimulated by strenuous exercise, full meals, cold, etc., causing an increase in platelets in the peripheral blood. The increase in platelets due to these conditions is considered to be a “physiological platelet increase” (commonly known as “pseudo-platelet increase”), and the patient’s true platelet count is determined again after these factors are removed. This condition is temporary and requires no special treatment. (2) Thrombocytosis due to chronic inflammation: For example: rheumatoid arthritis, acute rheumatic fever, periarteritis nodosa, Wegener’s granulomatosis, ulcerative colitis, tuberculosis, nodular disease, chronic lung abscess, osteomyelitis, etc. These chronic inflammatory conditions can cause thrombocytosis. (3) Thrombocytosis due to acute inflammation: e.g., recovery from various acute infections. (4) Platelet increase due to acute and chronic blood loss: The increase in platelet count after acute and chronic blood loss is mainly due to a physiological protective response of the body to limit further blood loss, and generally the platelets can return to normal within a short period of time after this condition bleeding control. (5) Platelet count increase due to iron deficiency anemia: In patients with iron deficiency anemia, the platelet count may increase, and the platelet count may return to normal after iron supplementation treatment. (6) Thrombocytosis due to hemolytic anemia: Thrombocytosis due to hemolytic anemia may increase the platelet count, and it is recommended to treat the hemolytic anemia actively, and the platelet count can be gradually restored after the condition is controlled. (7) Thrombocytosis due to malignant tumors: some malignant tumors, such as lung cancer patients can have increased schooling during the progression of the disease, it is recommended to treat the primary tumor, such patients are prone to coagulation disorders, attention should be paid to prevent the risk of bleeding and embolism. (8) Increased platelets after splenectomy: the spleen has the role of phagocytosis of aging cells in the blood, so the platelet count may rise to 1000×109/L or higher within 1 week after splenectomy, and generally return to normal within 2 months. (9) Platelet increase due to drug reaction: drugs (vincristine, epinephrine, interleukin-1β) and so on can increase platelet reactivity, which can gradually recover after stopping the drug. (10) Thrombocytopenia recovery period (rebound) thrombocytosis: myelosuppressive drugs (alcohol, methotrexate) or vitamin B12 deficiency caused by thrombocytopenia given to correct the treatment, can be 10-17 days after the treatment of platelet counts reached a peak, this situation does not need to deal with, after gradually return to normal. (11) Thrombocytosis due to osteoporosis: It is recommended to actively improve osteoporosis, and platelets can also gradually decrease after giving treatment. (2) Treatment Secondary thrombocytosis treatment is mainly aimed at the original disease, the original disease can be effectively treated after the platelets can often return to normal. If the platelet count is >1000×109/L and there is a high risk of thromboembolism, anti-platelet aggregation drugs such as aspirin and dipyridamole tablets can be added as appropriate to prevent complications of thromboembolism; for those who have thromboembolic symptoms, heparin therapy can be given. Heparin therapy can be given. (C) Prognosis Prognosis mainly depends on the primary disease, secondary thrombocytosis generally does not have an important impact on the prognosis.