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子痫前期:血小板计数及指标对其预后有帮助吗?

Preeclampsia: are platelet count and indices useful for its prognostic?

作者信息

Freitas Letícia Gonçalves, Alpoim Patrícia Nessralla, Komatsuzaki Flávia, Carvalho Maria das Graças, Dusse Luci Maria S

机构信息

Universidade Federal de Minas Gerais, Brazil.

出版信息

Hematology. 2013 Nov;18(6):360-4. doi: 10.1179/1607845413Y.0000000098. Epub 2013 May 10.

Abstract

INTRODUCTION

Preeclampsia (PE) is characterized by hypertension and proteinuria after the 20th week gestation. The aim of this study was to investigate whether platelet count (PC) and platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT)) could predict severe form of preeclampsia (sPE).

METHODS

Three groups were evaluated; G1-pregnant with sPE (N = 29); G2-normotensive pregnant (N = 28) and Group 3: non-pregnant women (N = 30). Platelet parameters were obtained using the same automatic blood cells count. Statistical analysis was performed by analysis of variance, t-test, and receiver operating characteristic (ROC) curve. P ≤ 0.05 was considered significant.

RESULTS

Lower PC and PCT were observed in sPE comparing to normal pregnant (P = 0.031 and 0.035, respectively) and to non-pregnant women (P < 0.001 and 0.004, respectively). PDW was higher in sPE comparing to normotensive pregnant (P = 0.028) and to non-pregnant women (P < 0.001). MPV was higher in sPE comparing to normotensive pregnant and non-pregnant women (P = 0.05 and P < 0.001, respectively). Analysis from the ROC curve and its areas for each variable showed that the parameters have regular diagnostic significance, except for PCT, considered as not good for this purpose.

CONCLUSION

PC emerges as a good candidate for sPE diagnosis, since it is a simple and habitually done method, with lower cost and greater accessibility in the clinical laboratory. Further studies evaluating sequential PC and platelet indices throughout pregnancy are necessary to clarify the role of platelet parameters in PE development and severity.

摘要

引言

子痫前期(PE)的特征是妊娠20周后出现高血压和蛋白尿。本研究的目的是调查血小板计数(PC)和血小板指标(平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板压积(PCT))是否能够预测重度子痫前期(sPE)。

方法

评估了三组人群;G1组为患有sPE的孕妇(N = 29);G2组为血压正常的孕妇(N = 28),第3组为非孕妇(N = 30)。使用相同的自动血细胞计数仪获取血小板参数。采用方差分析、t检验和受试者工作特征(ROC)曲线进行统计分析。P≤0.05被认为具有统计学意义。

结果

与正常孕妇相比(分别为P = 0.031和0.035)以及与非孕妇相比(分别为P < 0.001和0.004),sPE患者的PC和PCT较低。与血压正常的孕妇相比(P = 0.028)以及与非孕妇相比(P < 0.001),sPE患者的PDW较高。与血压正常的孕妇和非孕妇相比,sPE患者的MPV较高(分别为P = 0.05和P < 0.001)。对ROC曲线及其各变量的面积分析表明,除PCT外,这些参数均具有常规诊断意义,PCT被认为不适用于此目的。

结论

PC是sPE诊断的良好候选指标,因为它是一种简单且临床实验室中常用的方法,成本较低且更易获得。有必要进一步研究评估整个孕期连续的PC和血小板指标,以阐明血小板参数在PE发生发展及严重程度中的作用。

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