平均血小板体积增加与原发性胆汁性肝硬化的组织学严重程度相关。
Increased mean platelet volume is related to histologic severity of primary biliary cirrhosis.
作者信息
Tahtaci Mustafa, Yurekli Oyku T, Bolat Aylin D, Balci Serdar, Akin Fatma E, Buyukasik Naciye S, Ersoy Osman
机构信息
aDeparment of Gastroenterology, Ataturk Education and Research Hospital Departments of bPathology cGastroentrology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
出版信息
Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1382-5. doi: 10.1097/MEG.0000000000000463.
AIM
To evaluate the main platelet volume (MPV) as a severity marker in patients with primary biliary cirrhosis (PBC).
MATERIALS AND METHODS
Thirty-nine patients with biopsy-proven and as yet untreated PBC followed between January 2008 and January 2015 were included in this study. Liver biopsies were categorized as early stage (stage 1 and 2 according to Scheuer's histological stage) and late stage (Scheuer's stage 3 and 4). As part of the routine evaluation, all PBC patients had their full blood count and biochemistry profile determined, where MPV, white blood cell count, hemoglobin, platelet count, red cell distribution width (RDW), alanine aminotransferase, aspartate aminotransferase (AST), gamma glutamyl transferase, alkaline phosphatase, and total bilirubin values were evaluated. Both groups were compared in terms of the RDW/platelet ratio, the AST platelet ratio index, and the neutrophil lymphocyte ratio.
RESULTS
Eighteen patients had early-stage disease (46.2%), whereas 21 PBC patients had late-stage disease (53.8%). There were no differences between groups in terms of routine hematological parameters (white blood cell count, platelet count, hemoglobin, RDW) or biochemical parameters (alanine aminotransferase, AST, gamma glutamyl transferase, alkaline phosphatase, total bilirubin, albumin) (P>0.05). Similarly, there were no differences in AST platelet ratio index, RDW/platelet ratio, or neutrophil lymphocyte ratio values between groups (P values 0.08, 0.19, and 0.14, respectively). The MPV and direct bilirubin were significantly higher in the advanced stage group compared with the early-stage group (11.08 vs. 9.73 fl, respectively, P=0.01 and 0.44 vs. 0.28 mg/dl, respectively, P=0.03). The area under the curve, cut-off value, sensitivity, and specificity of MPV and direct bilirubin for detecting advanced stage were 0.721, 10.3, 71%, and 66%, respectively, and 0.698, 0.23, 71%, and 66%, respectively.
CONCLUSION
MPV can be used as a noninvasive, simple, and effective parameter in patients with PBC to predict histological severity of the disease.
目的
评估平均血小板体积（MPV）作为原发性胆汁性肝硬化（PBC）患者病情严重程度的标志物。
材料与方法
本研究纳入了39例2008年1月至2015年1月期间活检确诊且未经治疗的PBC患者。肝活检分为早期（根据Scheuer组织学分期为1期和2期）和晚期（Scheuer分期3期和4期）。作为常规评估的一部分，所有PBC患者均进行了全血细胞计数和生化指标检测，评估了MPV、白细胞计数、血红蛋白、血小板计数、红细胞分布宽度（RDW）、丙氨酸氨基转移酶、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶、碱性磷酸酶和总胆红素值。比较两组的RDW/血小板比值、AST血小板比值指数和中性粒细胞淋巴细胞比值。
结果
18例患者为早期疾病（46.2%），而21例PBC患者为晚期疾病（53.8%）。两组在常规血液学参数（白细胞计数、血小板计数、血红蛋白、RDW）或生化参数（丙氨酸氨基转移酶、AST、γ-谷氨酰转移酶、碱性磷酸酶、总胆红素、白蛋白）方面无差异（P>0.05）。同样，两组间AST血小板比值指数、RDW/血小板比值或中性粒细胞淋巴细胞比值也无差异（P值分别为0.08、0.19和0.14）。晚期组的MPV和直接胆红素显著高于早期组（分别为11.08对9.73 fl，P=0.01；以及0.44对0.28 mg/dl，P=0.03）。MPV和直接胆红素检测晚期的曲线下面积、临界值、敏感性和特异性分别为0.721、10.3、71%和66%，以及0.698、0.23、71%和66%。
结论
MPV可作为PBC患者预测疾病组织学严重程度的无创、简单且有效的参数。
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