Liu Z, Perry L A, Morgan V
Department of Dermatology, The Royal Melbourne Hospital, Parkville, Australia.
Department of Medicine, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
Clin Exp Med. 2023 Jun;23(2):333-346. doi: 10.1007/s10238-022-00820-5. Epub 2022 Apr 4.
The role of platelet function indices-platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), immature platelet fraction (IPF), and platelet mass index (PMI)-in psoriasis is uncertain. This systematic review and meta-analysis aimed to evaluate the association of these platelet biomarkers with both presence and severity of psoriasis. We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from inception to November 2021. To evaluate the association of platelet function indices and psoriasis, we recorded mean differences (MD) and 95% confidence intervals (CI) as well as correlation coefficients (r) for each included study, and generated summary estimates using random-effects inverse-variance modelling. We screened 1,079 unique studies, and included 33 studies with 6724 patients in the quantitative analyses. Compared with controls, patients with psoriasis had higher PLT (MD 12.86 × 10/L, 95% CI 6.34-19.39, p < 0.001), MPV (MD 0.61fL, 95% CI 0.31-0.92, p < 0.001), and PCT (MD 0.05%, 95% CI 0.01-0.09, p = 0.010), but similar PDW (MD 0.16%, 95% CI -0.46-0.79, p = 0.610). Psoriasis Area and Severity Index (PASI) was weakly correlated with PLT (r 0.17, 95% CI 0.06-0.28, p = 0.003), MPV (r 0.36, 95% CI 0.22-0.49, p < 0.001), and PDW (r 0.17, 95% CI 0.08-0.26, p < 0.001). Study numbers were insufficient to judge the relationship of IPF and PMI with psoriasis presence, or PCT, IPF, and PMI with psoriasis severity. In summary, PLT, MPV, and PCT are significantly elevated in patients with psoriasis, and PLT, MPV, and PDW are weakly correlated with PASI. Future studies are needed to evaluate the independent diagnostic and prognostic potentials of these biomarkers in patients with psoriasis.
血小板功能指标——血小板计数（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板压积（PCT）、未成熟血小板比率（IPF）和血小板质量指数（PMI）——在银屑病中的作用尚不确定。本系统评价和荟萃分析旨在评估这些血小板生物标志物与银屑病的存在及严重程度之间的关联。我们检索了从创刊至2021年11月的MEDLINE（Ovid）、Embase（Ovid）和Cochrane图书馆。为了评估血小板功能指标与银屑病的关联，我们记录了每项纳入研究的平均差值（MD）和95%置信区间（CI）以及相关系数（r），并使用随机效应逆方差模型生成汇总估计值。我们筛选了1079项独特的研究，定量分析纳入了33项研究共6724例患者。与对照组相比，银屑病患者的PLT（MD 12.86×10⁹/L，95%CI 6.34 - 19.39，p < 0.001）、MPV（MD 0.61fL，95%CI 0.31 - 0.92，p < 0.001）和PCT（MD 0.05%，95%CI 0.01 - 0.09，p = 0.010）更高，但PDW相似（MD 0.16%，95%CI -0.46 - 0.79，p = 0.610）。银屑病面积和严重程度指数（PASI）与PLT（r 0.17，95%CI 0.06 - 0.28，p = 0.003）、MPV（r 0.36，95%CI 0.22 - 0.49，p < 0.001）和PDW（r 0.17，95%CI 0.08 - 0.26，p < 0.001）呈弱相关。研究数量不足以判断IPF和PMI与银屑病存在的关系，以及PCT、IPF和PMI与银屑病严重程度的关系。总之，银屑病患者的PLT、MPV和PCT显著升高，且PLT、MPV和PDW与PASI呈弱相关。未来需要开展研究以评估这些生物标志物在银屑病患者中的独立诊断和预后潜力。
