Tozkoparan Ergun, Deniz Omer, Ucar Ergun, Bilgic Hayati, Ekiz Kudret
Department of Pulmonary Medicine, Gulhane Military Medical Academy, Ankara, Turkey.
Clin Chem Lab Med. 2007;45(8):1009-13. doi: 10.1515/CCLM.2007.194.
Recent studies show that platelets have important roles in the immune system. Little is known about the clinical significance of platelet indices. Changes in platelet indices, including platelet distribution width (PDW), mean platelet volume (MPV) and plateletcrit, in pulmonary tuberculosis were investigated.
Platelet indices were quantified in 82 patients with active tuberculosis and 87 patients with inactive or non-tuberculous disease (controls). Radiological extent of the disease was assessed.
There were significantly higher PDW (40.9+/-23.5% vs. 27.0+/-14.5%), MPV (10.05+/-2.36 vs. 8.83+/-1.47 fL) and plateletcrit (0.330+/-0166% vs. 0.266+/-0.128%) values in the active tuberculosis group, which decreased significantly with anti-tuberculous therapy. Erythrocyte sedimentation rate and plateletcrit showed significant correlation (r=0.54 and r=0.66) with radiological extent of tuberculosis, while PDW and MPV correlations with radiological extent of tuberculosis were also significant but weaker (r=0.31 and r=0.23). In a subpopulation of controls with pneumonia, which leads to acute phase reaction, PDW, MPV and plateletcrit values were significantly lower than in the tuberculosis group.
We suggest that PDW, MPV and plateletcrit change in tuberculosis and that these changes may not reflect only acute phase reaction and disease activity. The potential role of platelet indices in tuberculosis immunopathogenesis remains to be investigated.
近期研究表明，血小板在免疫系统中发挥重要作用。关于血小板指标的临床意义，人们了解甚少。本研究对肺结核患者血小板指标的变化进行了调查，这些指标包括血小板分布宽度（PDW）、平均血小板体积（MPV）和血小板压积。
对82例活动性肺结核患者和87例非活动性或非结核性疾病患者（对照组）的血小板指标进行定量分析，并评估疾病的放射学范围。
活动性肺结核组的PDW（40.9±23.5% vs. 27.0±14.5%）、MPV（10.05±2.36 vs. 8.83±1.47 fL）和血小板压积（0.330±0.166% vs. 0.266±0.128%）值显著更高，且随着抗结核治疗显著降低。红细胞沉降率和血小板压积与肺结核的放射学范围呈显著相关性（r = 0.54和r = 0.66），而PDW和MPV与肺结核放射学范围的相关性也显著，但较弱（r = 0.31和r = 0.23）。在导致急性期反应的肺炎对照组亚组中，PDW、MPV和血小板压积值显著低于肺结核组。
我们认为肺结核患者的PDW、MPV和血小板压积会发生变化，且这些变化可能不仅反映急性期反应和疾病活动。血小板指标在肺结核免疫发病机制中的潜在作用仍有待研究。
