Köleli Işıl
Department of Gynecology and Obstetrics, İnönü University Faculty of Medicine, Malatya, Turkey.
Balkan Med J. 2015 Oct;32(4):410-3. doi: 10.5152/balkanmedj.2015.151092. Epub 2015 Oct 1.
Adnexal torsion (AT) is among the gynecological emergencies; more common in reproductive age, if diagnosed late, this can cause ovarian failure and infertility, but rarely thrombophlebitis and peritonitis. Despite these severe complications, preoperative diagnostic tests are not enough for early diagnosis. There are certain pieces of literature on the subject that reveal changes in mean platelet volume (MPV) values occur in inflammatory and ischemic diseases and that these changes have diagnostic and prognostic significance. However, there are no studies investigating this relationship with adnexal torsion.
The aim of the study is to investigate the diagnostic and prognostic significance of the mean platelet volume value in the early diagnosis of patients with adnexal torsion.
Case-control study.
Pre-operative demographic data, MPV, leukocyte count and neutrophils to lymphocytes (N/L) ratio in the blood samples of 51 patients, who were operated on preliminary adnexal torsion and diagnosed as adnexal torsion with a benign ovarian cyst (AT group) were retrospectively compared with those of 50 patients who were operated upon because of benign ovarian cysts and without torsion (control group) at this hospital between 2006 and 2014.
The mean MPV level was found to be 8.1 (7.1-10.7) fL in the AT group and 7.9 (6.6-10.2) fL in the control group; no statistically significant difference was found between the groups (p>0.05). Leukocyte count and N/L ratio in the AT group were, on average, 12×10(3)/mm(3) and 82% respectively and in control group; they were, on average, 7.2×10(3)/mm(3) and 59%, respectively. A statistically significant increase was found in the leukocyte count and N/L ratio of the AT group compared to the control group (p<0.001). The platelet count in the AT group was, on average, 253×10(3)/mm(3) and in the control group it was, on average, 280×10(3)/mm(3); no statistically significant difference was detected between these two groups (p>0.05). No correlation was detected between the MPV, platelet and leukocyte counts. The sensitivity of the leukocytosis to the AT cases was found to be 66.7%, and selectivity was 94%.
The AT diagnostic and prognostic importance of MPV value has not been determined in this study.
附件扭转（AT）属于妇科急症；在育龄期更为常见，若诊断延迟，可导致卵巢功能衰竭和不孕，但很少引发血栓性静脉炎和腹膜炎。尽管存在这些严重并发症，但术前诊断检查尚不足以实现早期诊断。关于该主题有一些文献表明，平均血小板体积（MPV）值在炎症性和缺血性疾病中会发生变化，且这些变化具有诊断和预后意义。然而，尚无研究探讨其与附件扭转的这种关系。
本研究旨在探讨平均血小板体积值在附件扭转患者早期诊断中的诊断和预后意义。
病例对照研究。
回顾性比较了2006年至2014年间在本院因初步诊断为附件扭转且诊断为伴有良性卵巢囊肿的附件扭转（AT组）而接受手术的51例患者血液样本中的术前人口统计学数据、MPV、白细胞计数和中性粒细胞与淋巴细胞（N/L）比值，与因良性卵巢囊肿且无扭转而接受手术的50例患者（对照组）的相关数据。
AT组的平均MPV水平为8.1（7.1 - 10.7）fL，对照组为7.9（6.6 - 10.2）fL；两组之间未发现统计学上的显著差异（p>0.05）。AT组的白细胞计数和N/L比值平均分别为12×10³/mm³和82%，而对照组平均分别为7.2×10³/mm³和59%。与对照组相比，AT组的白细胞计数和N/L比值有统计学上的显著升高（p<0.001）。AT组的血小板计数平均为253×10³/mm³，对照组平均为280×10³/mm³；两组之间未检测到统计学上的显著差异（p>0.05）。未检测到MPV、血小板和白细胞计数之间的相关性。白细胞增多对AT病例的敏感性为66.7%（选择性为94%）。
本研究未确定MPV值对附件扭转的诊断和预后重要性。
