Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, Zhejiang Province, China.
Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, China.
Updates Surg. 2021 Aug;73(4):1327-1341. doi: 10.1007/s13304-020-00928-x. Epub 2021 Jan 13.
Correlation between blood inflammatory parameters and acute appendicitis (AA) remains controversial. This meta-analysis aims to evaluate whether platelet (PLT) indices including mean platelet volume (MPV), PLT count, and platelet distribution width (PDW) are associated with AA. Pubmed, Embase, and Cochrane Library databases were searched for observational studies published from inception through April 2020 by two independent investigators. Studies reporting associations between platelet indices and AA were selected for inclusion. Standardized mean difference (SMD) and 95% confidence interval (CI) were estimated for continuous outcomes using a DerSimonian-Laird random-effects model. Of 842 records identified, 17 studies with a total of 6793 subjects met our inclusion criteria. Meta-analysis indicated that compared with those in healthy controls, significant decrease in MPV levels was observed in subjects with AA (SMD - 0.34; 95% CI - 0.56 to - 0.12; P = 0.003). Subgroup analyses represented a significant reduction of MPV levels in patients aged ≥ 30 years and non-complicated/non-perforated AA. Due to the small number of studies and patients included in each subgroup, these subgroup analyses need to be interpreted with caution. However, none of the levels of PLT (SMD - 0.13; 95% CI - 0.28-0.012; P = 0.071) or PDW (SMD 0.30; 95% CI - 0.22-0.83; P = 0.257) was seen decrease or increase in subjects with AA. This meta-analysis indicates a significant decrease in MPV levels in patients with AA, which makes MPV have the potential of serving as a biomarker for AA. The associations of other PLT indices with AA need to be further examined.
血小板参数与急性阑尾炎（AA）之间的相关性仍存在争议。本荟萃分析旨在评估平均血小板体积（MPV）、血小板计数和血小板分布宽度（PDW）等血小板指数是否与 AA 相关。两位独立的研究者通过 Pubmed、Embase 和 Cochrane Library 数据库检索了从成立到 2020 年 4 月发表的观察性研究。选择报告血小板指数与 AA 之间相关性的研究进行纳入。使用 DerSimonian-Laird 随机效应模型对连续性结局评估标准化均数差（SMD）和 95%置信区间（CI）。在 842 条记录中，有 17 项研究共 6793 例患者符合纳入标准。荟萃分析表明，与健康对照组相比，AA 患者的 MPV 水平显著降低（SMD -0.34；95%CI -0.56 至 -0.12；P=0.003）。亚组分析显示，年龄≥30 岁的患者和非复杂/非穿孔性 AA 患者的 MPV 水平显著降低。由于每个亚组中包含的研究和患者数量较少，因此需要谨慎解释这些亚组分析。但是，AA 患者的血小板（SMD -0.13；95%CI -0.28 至 0.012；P=0.071）或 PDW（SMD 0.30；95%CI -0.22 至 0.83；P=0.257）水平未见降低或升高。本荟萃分析表明，AA 患者的 MPV 水平显著降低，这使得 MPV 有可能成为 AA 的生物标志物。其他血小板指数与 AA 的相关性需要进一步研究。
