Douda T, Bures J, Rejchrt S, Kopácová M, Pecka M, Malý J
II. interní klinika LF a FN, Hradec Králové.
Cas Lek Cesk. 2006;145(11):870-3.
Platelets are involved in the pathogenesis of chronic inflammation. Thrombocyte count and platelet volume are considered as a useful activity marker of inflammatory bowel disease. The aim of the study was to compare the yield of mean platelet volume with clinical and other laboratory markers of activity in Crohn's disease (CD).
A total of 56 patients with CD were investigated at time of evident clinical relapse and remission (29 males and 27 females, aged 19-68 years, mean 34.5, median 31.5 years). Complete blood count, C- reactive proteins were measured. Disease activity was assed by the Crohn's Disease Activity Index (CDAI). Patients were checked at least twice (120 analyses were carried out in total). Thrombocytosis (above 350xl09/L) was found in 32/61 (52 %) patients with clinical relapse and in 7/59 (12 %) patients with clinical remission (mean 400.7x10(9)/1; 95%CI: 361.1-440.3x10(9)/1; or as the case may be mean 278.6xl0(9)/1; 95% CI: 256.8-300.4x10(9)/1). The mean platelet volume decreased (under 7.8 fL) in 19/61 (31 %) patients with clinical relapse and in 8/59 (13.5 %) with clinical remission (mean 8.333 fl; 95% CI: 7.935-8.731 fl; or as the case may be mean 9.200 fl; 95% CI: 8.824-9.576 fl). Total platelet count, CDAI and C- reactive protein were significantly increased (p<0.0001) and mean platelet volume was statistically significantly reduced (p=0.003) during clinical relapse compared with clinical remission.
Decreased mean platelet corpuscular volume is an independent laboratory marker of clinical disease activity. However, on the basis of our study, its predictive value is inferior compared to the total platelet count, serum concentration of C- reactive protein and Crohn's disease activity index.
血小板参与慢性炎症的发病机制。血小板计数和血小板体积被视为炎症性肠病的有用活性标志物。本研究的目的是比较克罗恩病(CD)患者平均血小板体积与临床及其他活性实验室标志物的情况。
共对56例CD患者在明显临床复发和缓解期进行了调查(男性29例,女性27例,年龄19 - 68岁,平均34.5岁,中位数31.5岁)。检测了全血细胞计数、C反应蛋白。通过克罗恩病活动指数(CDAI)评估疾病活动度。患者至少接受了两次检查(共进行了120次分析)。在临床复发的32/61(52%)例患者和临床缓解的7/59(12%)例患者中发现血小板增多(高于350×10⁹/L)(分别为平均400.7×10⁹/L;95%可信区间:361.1 - 440.3×10⁹/L;或视情况而定平均278.6×10⁹/L;95%可信区间:256.8 - 300.4×10⁹/L)。在临床复发的19/61(31%)例患者和临床缓解的8/59(13.5%)例患者中平均血小板体积降低(低于7.8 fL)(分别为平均8.333 fL;95%可信区间:7.935 - 8.731 fL;或视情况而定平均9.200 fL;95%可信区间:8.824 - 9.576 fL)。与临床缓解期相比,临床复发期血小板总数、CDAI和C反应蛋白显著升高(p < 0.0001),平均血小板体积在统计学上显著降低(p = 0.003)。
平均血小板体积降低是临床疾病活动度的一个独立实验室标志物。然而,基于我们的研究,其预测价值低于血小板总数、血清C反应蛋白浓度和克罗恩病活动指数。