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血小板参数在子痫前期严重程度的早期检测和预测中的作用:埃塞俄比亚提格雷州梅开勒市 Ayder 综合专科医院和 Mekelle 综合医院的对比横断面研究。

Role of platelet parameters in early detection and prediction of severity of preeclampsia: A comparative cross-sectional study at Ayder comprehensive specialized and Mekelle general hospitals, Mekelle, Tigray, Ethiopia.

机构信息

Department of Medical laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

PLoS One. 2019 Nov 21;14(11):e0225536. doi: 10.1371/journal.pone.0225536. eCollection 2019.

Abstract

BACKGROUND

Platelet parameters alterations are one of the most commonly identified hematological changes in preeclampsia (PE). However, their functions as a tool for prediction and prognosis of PE have not been extensively studied in developing countries. The aim of this study was to compare platelet count (PC), and platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR)) between preeclamptic and normotensive (NT) pregnant women and assess their role in diagnosis and prediction of PE development.

METHODS

A cross sectional comparative study was conducted at Ayder comprehensive specialized hospital (ACSH) and Mekelle general hospital (MGH) from January to March 2017. Platelet parameters of mild preeclamptic (mPE) (n = 35), severe preeclamptic (sPE) (n = 44) and NT pregnant women (n = 140) were analyzed using SYSMEX-XT 4000i automated hematology analyzer. One-way ANOVA supplemented with post-hoc test, receiver operating characteristics (ROC) curve and pearson correlation test statistical analyses were performed. P < 0.05 was considered significant.

RESULT

Pregnant women with sPE had lower PC as compared with that of mPE and NT women (p<0.05). All platelet indices showed significant increment with severity of PE. PC was negatively correlated with platelet indices. There was a positive correlation among platelet indices. ROC analysis revealed that MPV had the largest area under the ROC curve (0.85; 95%CI (0.79, 0.89)) with cutoff value >9.45fl, sensitivity of 83.5%, specificity of 86.4%, positive predictive value of 77.6% and negative predictive value of 90.3%.

CONCLUSION

MPV and PC were identified as good candidates for sPE diagnosis. Because evaluation of platelet parameters is rapid, reliable and economical, they can be utilized as an alternative biomarker for prediction and prognosis of PE.

摘要

背景

血小板参数改变是子痫前期(PE)最常见的血液学变化之一。然而,在发展中国家,它们作为预测和预后 PE 的工具的功能尚未得到广泛研究。本研究旨在比较子痫前期(PE)和正常血压(NT)孕妇的血小板计数(PC)和血小板指数(平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板大细胞比(PLCR)),并评估它们在诊断和预测 PE 发展中的作用。

方法

本研究采用横断面比较研究,于 2017 年 1 月至 3 月在阿德尔综合专科医院(ACSH)和梅克尔综合医院(MGH)进行。使用 SYSMEX-XT 4000i 自动化血液分析仪分析轻度子痫前期(mPE)(n=35)、重度子痫前期(sPE)(n=44)和 NT 孕妇(n=140)的血小板参数。采用单因素方差分析(ANOVA),并进行事后检验、受试者工作特征(ROC)曲线和皮尔逊相关检验分析。P<0.05 被认为具有统计学意义。

结果

与 mPE 和 NT 孕妇相比,sPE 孕妇的 PC 较低(p<0.05)。所有血小板指数均随 PE 严重程度的增加而显著升高。PC 与血小板指数呈负相关。血小板指数之间呈正相关。ROC 分析显示,MPV 的 ROC 曲线下面积最大(0.85;95%CI(0.79,0.89)),截断值>9.45fl,敏感性为 83.5%,特异性为 86.4%,阳性预测值为 77.6%,阴性预测值为 90.3%。

结论

MPV 和 PC 被确定为 sPE 诊断的良好候选者。由于血小板参数的评估快速、可靠且经济,因此它们可作为预测和预后 PE 的替代生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c544/6874061/8447878a2f0f/pone.0225536.g001.jpg

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