TR HSU Diyarbakır Gazi Yaşargil TRH, Department of Anesthesiology and Reanimation, Elazığ Yolu 10. Km Üçkuyular Mevkii 21070, Diyarbakır, Turkey.
Pain Res Manag. 2020 Aug 7;2020:6015309. doi: 10.1155/2020/6015309. eCollection 2020.
In this study, considering the importance of platelet function in inflammatory processes, we explored whether there are relationships of platelet indices with postdural puncture headache (PDPH) and pain developing after use of spinal needles and whether patient characteristics contribute to the development of PDPH.
This prospective, observational study included 76 patients (Group 1) with PDPH and 93 patients (Group 2) without PDPH. The postoperative hemoglobin, hematocrit, platelet count (PC), and mean platelet volume (MPV) values were recorded, along with age, blood type, Rh factor, gravida, parity, and gestational age. In addition, the time of the onset of pain was recorded in patients who complained of a postspinal headache.
Hemoglobin and hematocrit values in Group 1 were significantly lower than in Group 2 (both, =0.024). The PC of Group 1 was significantly higher than that of Group 2 ( < 0.001), whereas the MPV was significantly lower ( < 0.001). The area under the curve (AUC) values were significant for hemoglobin, hematocrit, PC, and MPV (=0.022, =0.024, < 0.001, and < 0.001, resp.). For MPV, the AUC value was 0.293, sensitivity was 1%, and specificity was 99%. The highest likelihood ratio (LR+) value was 1.22 at a cut-off value of 13.3 fL. For the PC, the AUC value was 0.666, the sensitivity was 9%, and the specificity was 99%, while the highest LR + value was 8.56 at a cut-off value of 352 × 10/L. There was no significant relationship between the parameters examined and the onset of pain.
In this study, the PC was higher and MPV was lower in obstetric patients with PDPH compared with the control group. However, we also found that these two values cannot be used as markers of PDPH.
在这项研究中，考虑到血小板功能在炎症过程中的重要性，我们探讨了血小板指数与椎管穿刺后头痛（PDPH）和使用脊髓针后疼痛发展之间是否存在关系，以及患者特征是否有助于 PDPH 的发展。
这项前瞻性、观察性研究纳入了 76 例 PDPH 患者（第 1 组）和 93 例无 PDPH 患者（第 2 组）。记录术后血红蛋白、血细胞比容、血小板计数（PC）和平均血小板体积（MPV）值，以及年龄、血型、Rh 因子、孕次、产次和胎龄。此外，在出现脊髓后头痛的患者中记录疼痛发生的时间。
第 1 组的血红蛋白和血细胞比容值明显低于第 2 组（均，=0.024）。第 1 组的 PC 明显高于第 2 组（<0.001），而 MPV 明显较低（<0.001）。血红蛋白、血细胞比容、PC 和 MPV 的曲线下面积（AUC）值均有统计学意义（=0.022、=0.024、<0.001 和 <0.001）。对于 MPV，AUC 值为 0.293，灵敏度为 1%，特异性为 99%。截断值为 13.3 fL 时，最高似然比（LR+）值为 1.22。对于 PC，AUC 值为 0.666，灵敏度为 9%，特异性为 99%，而截断值为 352×10/L 时，最高 LR+值为 8.56。检查的参数与疼痛的发生之间没有显著关系。
在这项研究中，与对照组相比，患有 PDPH 的产科患者的 PC 更高，MPV 更低。然而，我们还发现这两个值不能作为 PDPH 的标志物。
