Naeimi Bafghi Neda, Torabi Mehdi, Ashkar Fatemeh, Mirzaee Moghaddameh
Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Caspian J Intern Med. 2024 Oct 22;16(1):151-157. doi: 10.22088/cjim.16.1.151. eCollection 2025 Winter.
The aim of this study was to investigate the diagnostic accuracy of mean platelet volume (MPV) in predicting SBP in cirrhotic patients.
This was an observational, analytical, and retrospective study conducted on cirrhotic patients with abdominal ascites referred to the emergency department (ED) over a 1-year period. The cirrhotic patients with ascites were divided into two groups with or without SBP. The diagnostic accuracy of MPV for detecting SBP was measured and compared with the analysis of the ascites fluid obtained by paracentesis as a gold standard procedure in the absence of any secondary causes of peritonitis. The required data were documented in a checklist.
A total of 252 patients, 126 with SBP and 126 without SBP, were included in the study. The mean MPV in these patients was 8.36 ± 0.92 fL. Patients with SBP had a significantly longer duration of cirrhosis, more severe fever and abdominal pain, and higher ascites WBC and PMN counts and higher mean MPV (p<001). At the most appropriate cut-off point (i.e., 8.3 fL), MPV provided the sensitivity, specificity, positive predictive value, negative predictive value, and the diagnostic accuracy of 69.84%, 53.97%, 60.27%, 64.15%, and 61.90%, respectively, for the diagnosis of SBP. The receiver operating characteristic (ROC) curve showed that MPV had an acceptable diagnostic accuracy (AUC = 0.677).
Mean platelet volume, as a non-invasive, simple, and accessible laboratory parameter, with acceptable diagnostic accuracy in cirrhotic patients with ascites may have a predictive role in the diagnosis of SBP.
本研究旨在探讨平均血小板体积（MPV）对肝硬化患者自发性细菌性腹膜炎（SBP）的诊断准确性。
这是一项对因腹水而转诊至急诊科的肝硬化患者进行的为期1年的观察性、分析性和回顾性研究。将有腹水的肝硬化患者分为有或无SBP的两组。测量MPV对检测SBP的诊断准确性，并与在无任何继发性腹膜炎病因的情况下通过腹腔穿刺术获得的腹水分析结果进行比较，腹腔穿刺术为金标准程序。所需数据记录在检查表中。
本研究共纳入252例患者，其中126例有SBP，126例无SBP。这些患者的平均MPV为8.36±0.92fL。有SBP的患者肝硬化病程明显更长，发热和腹痛更严重，腹水白细胞和中性粒细胞计数更高，平均MPV也更高（p<0.01）。在最合适的截断点（即8.3fL）时，MPV对SBP诊断的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为69.84%、53.97%、60.27%、64.15%和61.90%。受试者工作特征（ROC）曲线显示MPV具有可接受的诊断准确性（曲线下面积[AUC]=0.677）。
平均血小板体积作为一种无创、简单且易于获取的实验室参数，在有腹水的肝硬化患者中具有可接受的诊断准确性，可能在SBP的诊断中具有预测作用。
