Chen Chi, Song Jun, Wang Qing, Wang Lin-Hui, Guo Peng-Xiang
a Department of Immunology and Microbiology , Guiyang College of Traditional Chinese Medicine , Guiyang , Guizhou , People's Republic of China.
b Department of Hematology , The People's Hospital of Guizhou Province , Guiyang , Guizhou , People's Republic of China.
Hematology. 2018 Oct;23(9):646-652. doi: 10.1080/10245332.2018.1461317. Epub 2018 Apr 10.
In China, the ability of the current immune thrombocytopenia (ITP) guideline to stratify recurrent risk at diagnosis is limited. This study aimed to investigate whether mean platelet volume at diagnosis (MPV) is a risk factor for ITP relapse in Chinese.
The present study was a retrospective cohort study. Two hundred thirty-three adult patients with newly diagnosed ITP were consecutively and nonselectively collected from March 2013 to June 2017. The exposure and outcome variable were MPV at baseline and relapse-free survival at 6 months. Other covariants included demographic data, general information, variables that can affect MPV reported by previous literature and risk factors of ITP relapse.
After adjusting potential confounders, the non-linear relationship was detected between MPV and ITP relapse, and inflection point was 21. The effect sizes and the confidence intervals on the left and right sides of inflection point were 1.30 (1.22-1.39) and 0.89 (0.76-1.04), respectively. Subgroup analysis showed, in subjects with hyperuricemia (1.54 (1.24, 1.90)), MPV showed significant differences from non-hyperuricemia (1.19 (1.13, 1.25)), and the p for interaction was less than 0.05.
The relationship between MPV and ITP relapse is non-linear. MPV is an independent risk factor of ITP relapse when MPV is less than 21 fl.
在中国，目前免疫性血小板减少症（ITP）指南在诊断时对复发风险进行分层的能力有限。本研究旨在调查中国ITP患者诊断时的平均血小板体积（MPV）是否为ITP复发的危险因素。
本研究为回顾性队列研究。2013年3月至2017年6月连续非选择性收集233例新诊断的成年ITP患者。暴露变量和结局变量分别为基线时的MPV和6个月时的无复发生存率。其他协变量包括人口统计学数据、一般信息、先前文献报道的可影响MPV的变量以及ITP复发的危险因素。
调整潜在混杂因素后，检测到MPV与ITP复发之间存在非线性关系，拐点为21。拐点左右两侧的效应量和置信区间分别为1.30（1.22 - 1.39）和0.89（0.76 - 1.04）。亚组分析显示，在高尿酸血症患者中（1.54（1.24，1.90）），MPV与非高尿酸血症患者（1.19（1.13，1.25））存在显著差异，交互作用p值小于0.05。
MPV与ITP复发之间的关系是非线性的。当MPV小于21 fl时，MPV是ITP复发的独立危险因素。
