Ankara Numune Education and Research Hospital, Internal Medicine Department, Ankara, Turkey.
Ankara Numune Education and Research Hospital, Internal Medicine Department, Ankara, Turkey.
Am J Emerg Med. 2019 Apr;37(4):657-663. doi: 10.1016/j.ajem.2018.07.008. Epub 2018 Jul 3.
We aimed to investigate the association between platelet indices [platelet, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW)] and gastrointestinal bleeding (GIB), as well as determine its severity and prognosis.
500 patients with GIB who were admitted to hospital between March 2014 and February 2017 and diagnosed with "Gastrointestinal System Bleeding", as well as114 healthy individuals were retrospectively included in the study. Patients' platelet indices were recorded after one week and one month from their files.
Platelet, PCT, MPV and PDW levels were determined to be higher in the patients with bleeding, when compared to the control group (p < 0.001). Within the first week, a significant reduction was determined in patients' platelet, PCT, MPV and PDW values compared to the admission values (p < 0.001). In initial-month controls, a significant reduction was determined in the platelet indices compared to the initial-week values (p < 0.001). A significant association between bleeding severity and increased platelet indexes was determined. Increasing age, female gender, the presence of comorbidities, high levels of platelet indexes, low levels of hemoglobin, and albumin values were all found to be associated with a poor prognosis. PCT, MPV, and PDW were determined as being the independent risk factors that predict the odds of GIB, alongside the independent predictors that predict risk of bleeding severity and the prognosis.
We think that platelet indices may be used in diagnosis of GIB, as well as in predicting bleeding severity and the prognosis.
本研究旨在探讨血小板参数（血小板、血小板压积（PCT）、平均血小板体积（MPV）和血小板分布宽度（PDW））与胃肠道出血（GIB）之间的关系，并确定其严重程度和预后。
回顾性纳入 2014 年 3 月至 2017 年 2 月期间因“消化系统出血”住院的 500 例 GIB 患者和 114 名健康对照者。记录患者入院后第 1 周和第 1 个月的血小板参数。
与对照组相比，出血患者的血小板、PCT、MPV 和 PDW 水平更高（p<0.001）。与入院时相比，患者的血小板、PCT、MPV 和 PDW 值在第 1 周内显著降低（p<0.001）。在最初的 1 个月内，与第 1 周相比，血小板指数显著降低（p<0.001）。出血严重程度与血小板指数升高之间存在显著相关性。年龄较大、女性、合并症、血小板指数升高、血红蛋白和白蛋白水平降低与预后不良有关。PCT、MPV 和 PDW 被确定为预测 GIB 发生风险的独立危险因素，以及预测出血严重程度和预后的独立预测因素。
我们认为血小板指数可用于 GIB 的诊断，并可预测出血严重程度和预后。
