Gálvez-Martínez Marisol, Servín-Caamaño Alfredo I, Pérez-Torres Eduardo, Salas-Gordillo Francisco, Rivera-Gutiérrez Xaira, Higuera-de la Tijera Fátima
Marisol Gálvez-Martínez, Eduardo Pérez-Torres, Francisco Salas-Gordillo, Fátima Higuera-de la Tijera, Gastroenterology Department, Hospital General de México "Dr. Eduardo Liceaga", Mexico City 06720, Mexico.
World J Hepatol. 2015 May 8;7(7):1001-6. doi: 10.4254/wjh.v7.i7.1001.
To identify a mean platelet volume (MPV) cutoff value which should be able to predict the presence of bacterial infection.
An observational, analytic, retrospective study. We evaluated medical records of cirrhotic patients who were hospitalized from January 2012 to January 2014 at the Gastroenterology Department of "Hospital General de México Dr. Eduardo Liceaga", we included 51 cirrhotic patients with ascites fluid infection (AFI), and 50 non-infected cirrhotic patients as control group. Receiver operator characteristic curves were used to identify the best cutoff value of several parameters from hematic cytometry, including MPV, to predict the presence of ascites fluid infection.
Of the 51 cases with AFI, 48 patients (94.1%) had culture-negative neutrocytic ascites (CNNA), 2 (3.9%) had bacterial ascites, and one (2%) had spontaneous bacterial peritonitis. Infected patients had greater count of leucocytes and polymorphonuclear cells, greater levels of MPV and cardiac frequency (P < 0.0001), and lower mean arterial pressure compared with non-infected patients (P = 0.009). Leucocytes, polymorphonuclear count, MPV and cardiac frequency resulted to be good or very good predictive variables of presence of AFI in cirrhotic patients (area under the receiving operating characteristic > 0.80). A cutoff MPV value of 8.3 fl was the best to discriminate between cirrhotic patients with AFI and those without infection.
Our results support that MPV can be an useful predictor of systemic inflammatory response syndrome in cirrhotic patients with AFI, particularly CNNA.
确定一个能够预测细菌感染存在的平均血小板体积（MPV）临界值。
一项观察性、分析性、回顾性研究。我们评估了2012年1月至2014年1月在“墨西哥城爱德华多·利塞加博士综合医院”胃肠病科住院的肝硬化患者的病历，纳入了51例伴有腹水感染（AFI）的肝硬化患者，以及50例未感染的肝硬化患者作为对照组。采用受试者工作特征曲线来确定血细胞计数仪中包括MPV在内的几个参数的最佳临界值，以预测腹水感染的存在。
在51例AFI病例中，48例患者（94.1%）患有培养阴性中性粒细胞性腹水（CNNA），2例（3.9%）患有细菌性腹水，1例（2%）患有自发性细菌性腹膜炎。与未感染患者相比，感染患者的白细胞和多形核细胞计数更高，MPV水平和心率更高（P<0.0001），平均动脉压更低（P=0.009）。白细胞、多形核细胞计数、MPV和心率是肝硬化患者AFI存在的良好或非常好的预测变量（受试者工作特征曲线下面积>0.80）。8.3 fl的MPV临界值最能区分患有AFI的肝硬化患者和未感染的患者。
我们的结果支持MPV可作为伴有AFI的肝硬化患者，尤其是CNNA患者全身炎症反应综合征的有用预测指标。
