Vilchez Gustavo, Lagos Moraima, Kumar Komal, Argoti Pedro
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, USA.
Federico Villareal National University, San Miguel, Lima, Peru.
J Obstet Gynaecol Res. 2017 Jun;43(6):982-990. doi: 10.1111/jog.13312. Epub 2017 Apr 19.
Platelet activation and destruction is a well recognized feature of pre-eclampsia, but the current literature is contradictory regarding the role of mean platelet volume (MPV) in the diagnosis of this condition. We investigated whether MPV, compared with other routine laboratory markers such as platelet count, is a more significant biomarker of pre-eclampsia, giving special attention to the intrapartum period.
Biochemical and hematological markers along pregnancy including MPV were compared retrospectively between pre-eclampsia and matched controls. Laboratory marker data were compared using independent t-test. A logistic regression model was used to compare the strength of the associations of MPV and other routine markers such as platelet count with pre-eclampsia. Receiver operating characteristic curves were plotted.
There were a total of 150 cases of pre-eclampsia and 297 controls. In the pre-eclampsia group, there were 60 cases of mild pre-eclampsia (40.0%); 84, severe (56.0%); and six of eclampsia (4.0%). MPV was significantly higher in the pre-eclampsia than in the control group (11.3 ± 1.0 vs 10.1 ± 0.8 fL, P = 0.002). On multivariate analysis, MPV was the only statistically significant biomarker of pre-eclampsia (OR, 4.5; 95%CI: 1.5-13.7), and severe pre-eclampsia (OR, 6.2; 95%CI: 1.6-24.6); performing superiorly to platelet count.
Mean platelet volume is a more significant biomarker of pre-eclampsia. It is more significantly associated with this condition than other routinely measured laboratory markers such as platelet count. MPV is routinely obtained on complete blood cell count and its utilization in the assessment of pre-eclampsia in a clinical setting should continue to be evaluated.
血小板活化和破坏是子痫前期公认的特征,但目前关于平均血小板体积(MPV)在该疾病诊断中的作用,文献观点存在矛盾。我们研究了与血小板计数等其他常规实验室指标相比,MPV是否是子痫前期更重要的生物标志物,并特别关注产时阶段。
回顾性比较子痫前期患者与匹配对照组在整个孕期包括MPV在内的生化和血液学指标。采用独立t检验比较实验室指标数据。使用逻辑回归模型比较MPV和血小板计数等其他常规指标与子痫前期的关联强度。绘制受试者工作特征曲线。
共有150例子痫前期患者和297例对照。子痫前期组中,轻度子痫前期60例(40.0%);重度84例(56.0%);子痫6例(4.0%)。子痫前期组的MPV显著高于对照组(11.3±1.0 vs 10.1±0.8 fL,P = 0.002)。多因素分析显示,MPV是子痫前期唯一具有统计学意义的生物标志物(OR,4.5;95%CI:1.5 - 13.7),以及重度子痫前期(OR,6.2;95%CI:1.6 - 24.6);其表现优于血小板计数。
平均血小板体积是子痫前期更重要的生物标志物。与血小板计数等其他常规检测的实验室指标相比,它与该疾病的关联更为显著。MPV是全血细胞计数的常规检测项目,其在临床环境中评估子痫前期的应用仍需继续评估。