Department of Cardiovascular Medicine, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002; Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, PR China.
Platelets. 2012;23(1):11-6. doi: 10.3109/09537104.2011.586073. Epub 2011 Jun 16.
Mean platelet volume (MPV) and platelet distribution width (PDW) are correlated with platelet function and may be a more sensitive index than platelet number as a marker of clinical interest in various disorders. Therefore, this study was designed to answer the following questions: do MPV and PDW levels change in Kawasaki disease (KD), is there any relation between CAL in children with MPV and PDW and whether MPV and PDW might support a diagnosis of incomplete KD. A total of 309 KD patients and 160 sex-age matched healthy subjects were enrolled into the study. For all subjects following tests were performed: MPV, PDW, platelet count, white blood cells counts (WBC), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Patients with CALs were assigned to three groups depending on the extent of CALs which were visualized by echocardiography: dilatation and/or ectasia, aneurysm and giant aneurysms. We compared patients with fever and four or five of the principal criteria (complete KD, cKD) to the other patients (iKD). Compared with healthy controls a significant decrease in MPV and PDW (p < 0.001 and p < 0.05, respectively) and increase in WBC, platelet count, CRP and ESR (p all < 0.001) was noted in children with KD. There were no statistically differences in MPV and PDW between KD with CALs and KD without CALs (p > 0.05). However, MPV and PDW were significantly lower in patients with iKD than in group with cKD (p = 0.003, p = 0.014, respectively). It was first shown that patients with KD have lower MPV and PDW than control subjects. The diagnosis of iKD is challenging but can be supported by the presence of lower MPV and PDW.
血小板平均体积（MPV）和血小板分布宽度（PDW）与血小板功能相关，并且可能比血小板计数更敏感，成为各种疾病临床关注的标志物。因此，本研究旨在回答以下问题：川崎病（KD）患者的MPV 和 PDW 水平是否发生变化，儿童的 MPV 和 PDW 与 CAL 之间是否存在关系，以及 MPV 和 PDW 是否可以支持不完全性 KD 的诊断。共纳入 309 例 KD 患者和 160 例性别年龄匹配的健康对照者。对所有受试者进行以下检测：MPV、PDW、血小板计数、白细胞计数（WBC）、C 反应蛋白（CRP）和红细胞沉降率（ESR）。根据超声心动图检测到的 CAL 程度，将有 CAL 的患者分为三组：扩张和/或扩张、动脉瘤和巨大动脉瘤。我们将有发热和四项或五项主要标准（完全性 KD，cKD）的患者与其他患者（iKD）进行比较。与健康对照组相比，KD 患儿的 MPV 和 PDW 显著降低（p<0.001 和 p<0.05），WBC、血小板计数、CRP 和 ESR 显著升高（p 均<0.001）。KD 合并 CAL 与无 CAL 患儿的 MPV 和 PDW 差异无统计学意义（p>0.05）。然而，iKD 患者的 MPV 和 PDW 明显低于 cKD 患者（p=0.003，p=0.014）。本研究首次表明，KD 患者的 MPV 和 PDW 低于对照组。iKD 的诊断具有挑战性，但较低的 MPV 和 PDW 可能有助于支持该诊断。
