Albrich Werner C, Rimland David
Division of Infectious Diseases, Veterans Affairs Medical Center, School of Medicine, Emory University, Atlanta, GA, USA.
South Med J. 2007 Feb;100(2):149-51. doi: 10.1097/SMJ.0b013e31802ea5ac.
Apart from leukocytosis, few laboratory markers suggestive of Clostridium difficile infections have been described.
We retrospectively analyzed the association between thrombocytosis, leukocytosis and C. difficile infections at the Atlanta Veterans Affairs Medical Center.
Of 162 patients with C. difficile infection, 36 (22%) had thrombocytosis, and 97 (60%) had leukocytosis. C difficile toxin A ELISA was performed in 46/695 (6.6%) patients with thrombocytosis and was positive in 18 (39.1%). Leukocytosis was present in 16/18 (89%) of patients with positive C. difficile toxin A ELISA and thrombocytosis, but also in 21/28 (75%) of patients with negative C. difficile toxin A ELISA and thrombocytosis. Among patients with marked leukocytosis, C. difficile toxin A was more frequently detected in those with concomitant thrombocytosis (P = 0.07).
The presence of thrombocytosis may be helpful to improve the pretest probability for C difficile infections.
除白细胞增多外，很少有提示艰难梭菌感染的实验室指标被描述。
我们回顾性分析了亚特兰大退伍军人事务医疗中心血小板增多、白细胞增多与艰难梭菌感染之间的关联。
在162例艰难梭菌感染患者中，36例（22%）有血小板增多，97例（60%）有白细胞增多。在46/695例（6.6%）血小板增多患者中进行了艰难梭菌毒素A酶联免疫吸附测定，18例（39.1%）呈阳性。艰难梭菌毒素A酶联免疫吸附测定阳性且有血小板增多的患者中16/18例（89%）有白细胞增多，而艰难梭菌毒素A酶联免疫吸附测定阴性且有血小板增多的患者中21/28例（75%）有白细胞增多。在有明显白细胞增多的患者中，合并血小板增多者更常检测到艰难梭菌毒素A（P = 0.07）。
血小板增多的存在可能有助于提高艰难梭菌感染的预检概率。
