酒精戒断综合征住院患者的血小板减少症及其与临床并发症的关系。
Thrombocytopenia in Patients Hospitalized for Alcohol Withdrawal Syndrome and Its Associations to Clinical Complications.
机构信息
Department of Prevention and Treatment of Addictions, Institute of Psychiatry and Neurology, Warsaw, Poland.
Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland.
出版信息
Alcohol Alcohol. 2019 Jan 9;54(5):503-509. doi: 10.1093/alcalc/agz061.
BACKGROUND
The aim of this study was to assess the predictive value of thrombocytopenia (TP) in alcohol withdrawal syndrome (AWS) as a marker of evolution of non-complicated AWS (nAWS) to severe, complicated AWS (cAWS): delirium tremens (DTs) and withdrawal seizures (wS), and to broaden knowledge about differences between nAWS and cAWS groups in relation to severity of TP.
METHODS
This study involved 300 people (236 males and 64 females), aged 19-65 years (M = 44.64, SD = 11.32), hospitalized in the detoxification ward with ICD-10 diagnosis of F10.3 (AWS) or F10.4 (DTs), divided into nAWS and cAWS groups, 150 cases each. AWS severity was measured by CIWA-Ar. Available clinical and laboratory data were analyzed.
RESULTS
TP was found in 139 (46%) of all subjects (nAWS = 32, cAWS = 107). nAWS and cAWS did not differ according to age, gender, length and severity of the last binge. A relationship between the occurrence of TP and cAWS was found (P < 0.001). The lower was the number of PLT, the more AWS incidence was observed. In CIWA-Ar, TP subjects had at least moderate AWS (P < 0.001). nAWS had higher PLT values than cAWS cases (Mrang = 195.96 vs. 105.04, P < 0.001). The predictive value of TP in cAWS was confirmed.
CONCLUSIONS
The study demonstrates that patients with AWS and TP (in particular <119k/mL) are at higher risk of developing cAWS.
背景
本研究旨在评估血小板减少症（TP）在酒精戒断综合征（AWS）中的预测价值，作为非复杂 AWS（nAWS）向严重、复杂 AWS（cAWS）（震颤谵妄（DTs）和戒断性癫痫发作（wS）演变的标志物，并拓宽对 nAWS 和 cAWS 组之间与 TP 严重程度相关的差异的认识。
方法
这项研究涉及 300 人（236 名男性和 64 名女性），年龄在 19-65 岁之间（M = 44.64，SD = 11.32），因 ICD-10 诊断为 F10.3（AWS）或 F10.4（DTs）而住院于戒毒病房，分为 nAWS 和 cAWS 组，每组 150 例。AWS 严重程度通过 CIWA-Ar 进行测量。分析了可用的临床和实验室数据。
结果
在所有受试者（nAWS = 32，cAWS = 107）中发现了 139 例（46%）TP。nAWS 和 cAWS 在年龄、性别、最后一次狂饮的持续时间和严重程度方面没有差异。发现 TP 的发生与 cAWS 之间存在关系（P < 0.001）。PLT 数量越低，AWS 发生率越高。在 CIWA-Ar 中，TP 患者至少有中度 AWS（P < 0.001）。nAWS 的 PLT 值高于 cAWS 病例（Mrang = 195.96 vs. 105.04，P < 0.001）。TP 在 cAWS 中的预测价值得到了证实。
结论
该研究表明，患有 AWS 和 TP（特别是 <119k/mL）的患者发生 cAWS 的风险更高。
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