Kaur Harmanpreet, Borhany Munira, Azzam Hanan, Costa-Lima Carolina, Ozelo Margareth, Othman Maha
aDepartment of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada bDepartment of Hematology, Hemostasis and Thrombosis, National Institute of Blood Disease and Bone Marrow Transplantation (NIBD), Karachi, Pakistan cDepartment of Clinical Pathology, Mansoura University, Mansoura, Egypt dINCT do Sangue Hemocentro Unicamp, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil eSchool of Baccalaureate Nursing, St Lawrence College, Kingston, Ontario, Canada.
Blood Coagul Fibrinolysis. 2016 Jul;27(5):589-93. doi: 10.1097/MBC.0000000000000496.
The main objective of this study is to investigate the utility of International Society on Thrombosis and Haemostasis-Bleeding Assessment Tool (ISTH-BAT) in comparison with the condensed form of Molecular and Clinical Markers for the Diagnosis and Management of type 1 and WHO BATs, in assessing bleeding in two well known and clinically significant platelet function defects. Thirty-eight patients previously diagnosed with Glanzmann's thrombasthenia and 10 with Bernard-Soulier syndrome (BSS) were analyzed. Bleeding scores were significantly higher than that of controls using both electronic bleeding questionnaire (eBQ) and ISTH-BAT with no significant difference between both tools. ISTH-BAT had a sensitivity, specificity, positive predictive value and negative predictive value of 100%, 76.2%, 0.9 and 1. This was closely similar to eBQ. Both ISTH-BAT and eBQ are efficient in BSS and Glanzmann's thrombasthenia. However, given the ISTH recommendation, ISTH-BAT should be adopted. Larger study including other platelet defects will enhance its utility and support the integration of bleeding scores with standardized laboratory testing to allow for a universal diagnostic approach to patients with suspected bleeding disorders.
本研究的主要目的是,将国际血栓与止血学会出血评估工具(ISTH-BAT)与1型诊断和管理的分子与临床标志物精简版以及世界卫生组织出血评估工具(WHO BATs)相比较,以调查其在评估两种广为人知且具有临床意义的血小板功能缺陷出血情况时的效用。分析了38例先前诊断为Glanzmann血小板无力症的患者和10例Bernard-Soulier综合征(BSS)患者。使用电子出血问卷(eBQ)和ISTH-BAT时,出血评分均显著高于对照组,且两种工具之间无显著差异。ISTH-BAT的敏感性、特异性、阳性预测值和阴性预测值分别为100%、76.2%、0.9和1。这与eBQ非常相似。ISTH-BAT和eBQ在BSS和Glanzmann血小板无力症中均有效。然而,根据ISTH的建议,应采用ISTH-BAT。纳入其他血小板缺陷的更大规模研究将提高其效用,并支持将出血评分与标准化实验室检测相结合,以便对疑似出血性疾病的患者采用通用的诊断方法。