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平均血小板体积、血小板分布宽度及血小板大细胞比率作为免疫性血小板减少症筛查工具的诊断重要性

Diagnostic importance of mean platelet volume, platelet distribution width and platelet large cell ratio as screening tool in immune thrombocytopenia.

作者信息

Khan Muhammad Ihtesham, Ullah Ihsan

机构信息

Assistant Professor (Hematology), Pathology Department, Khyber Medical College, Peshawar, Pakistan.

Associate Professor Pathology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan.

出版信息

Porto Biomed J. 2020 Nov 24;5(6):e094. doi: 10.1097/j.pbj.0000000000000094. eCollection 2020 Nov-Dec.

DOI:10.1097/j.pbj.0000000000000094
PMID:33283064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7710198/
Abstract

OBJECTIVE

To determine diagnostic importance of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (PLCR) in diagnosing cases of immune thrombocytopenia.

METHODOLOGY

The study was done in Khyber Teaching hospital from January 2017 to May 2018. Cases with low platelet count of all the ages and both the genders were included in the study by non probability purposive sampling technique and were subjected to bone marrow aspiration to rule out other causes of thrombocytopenia and thus confirm the diagnosis of immune thrombocytopenia. The platelet indices were noted and their sensitivity, specificity and accuracy were determined for immune thrombocytopenia. Mean and standard deviation were used for quantitative data. Percentage and frequency were used to measure qualitative data. Data was analysed by SPSS.

RESULTS

84 cases with thrombocytopenia of mean age 23.4 ± 12.1 years (range 7-81 years) were included in the study. There were 38 (45.2%) males and 46 (54.8%) females. There were 40 cases of immune thrombocytopenia. The sensitivity and specificity for PDW (59.1% and 43.1%, respectively), MPV (59.1% and 52.9%, respectively), and PLCR (50% and 52.9%, respectively) were found low to be used as screening tool for immune thrombocytopenia.

CONCLUSION

The MPV, PDW and PLCR has low sensitivity and specificity and therefore should not be used as reliable screening tool in giving preliminary diagnosis of the immune thrombocytopenia.

摘要

目的

确定平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板大细胞比率(PLCR)在免疫性血小板减少症诊断中的重要性。

方法

本研究于2017年1月至2018年5月在开伯尔教学医院进行。采用非概率目的抽样技术,纳入所有年龄和性别的血小板计数低的病例,并进行骨髓穿刺以排除血小板减少症的其他原因,从而确诊免疫性血小板减少症。记录血小板指数,并确定其对免疫性血小板减少症的敏感性、特异性和准确性。定量数据采用均值和标准差。百分比和频率用于衡量定性数据。数据通过SPSS进行分析。

结果

本研究纳入了84例血小板减少症患者,平均年龄为23.4±12.1岁(范围7 - 81岁)。其中男性38例(45.2%),女性46例(54.8%)。有40例免疫性血小板减少症。发现PDW(分别为59.1%和43.1%)、MPV(分别为59.1%和52.9%)和PLCR(分别为50%和52.9%)的敏感性和特异性较低,不能用作免疫性血小板减少症的筛查工具。

结论

MPV、PDW和PLCR的敏感性和特异性较低,因此不应作为免疫性血小板减少症初步诊断的可靠筛查工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/10a0a625e926/pj9-5-e094-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/9317c3ddf282/pj9-5-e094-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/8ea76ea9281e/pj9-5-e094-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/10a0a625e926/pj9-5-e094-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/9317c3ddf282/pj9-5-e094-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/8ea76ea9281e/pj9-5-e094-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/774b/7710198/10a0a625e926/pj9-5-e094-g003.jpg

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Blood Coagul Fibrinolysis. 2017 Jan;28(1):83-90. doi: 10.1097/MBC.0000000000000612.
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Screening tests: a review with examples.
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Inhal Toxicol. 2014 Nov;26(13):811-28. doi: 10.3109/08958378.2014.955932. Epub 2014 Sep 29.
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Platelet volume indices have low diagnostic efficiency for predicting bone marrow failure in thrombocytopenic patients.血小板体积指数对预测血小板减少症患者的骨髓衰竭诊断效率较低。
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Role of mean platelet volume as discriminating guide for bone marrow disease in patients with thrombocytopenia.平均血小板体积在血小板减少症患者骨髓疾病鉴别诊断中的作用。
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