摘要
目的探讨血小板参数在儿童免疫性血小板减少症(ITP)诊断中的应用,并分析其在正常儿童、ITP患儿及包虫病患儿中的差异性。方法选取新疆医科大学第一附属医院2019年2月-2022年10月收治的ITP患儿39例及包虫病患儿39例作为观察组,选择同期接受健康体检的78名儿童为对照组。对ITP患儿初诊时血小板参数[血小板计数(PC)、血小板分布宽度(PDW)、血小板平均体积(MPV)、血小板压积(PCT)]的相关性及各指标与年龄的相关性进行分析,对ITP患儿治疗前后血小板参数进行比较,并利用受试者工作特征(ROC)曲线分析血小板参数对ITP的诊断价值,比较正常儿童、ITP患儿及包虫病患儿血小板参数的差异性。结果ITP患儿初诊时PC与PCT之间存在显著正相关(r=0.959,P<0.05),PDW与MPV之间存在显著正相关(r=0.933,P<0.05),各参数与患儿年龄均无明显相关性。ITP患儿组治疗后PC[(154.44±84.31)×10^(9)/L vs.(36.20±34.12)×10^(9)/L]、PCT[(0.16±0.08)%vs.(0.04±0.04)%]较治疗前升高(t=8.117、8.046,均P<0.05),PDW[(13.07±4.40)fL vs.(16.90±5.48)fL]、MPV[(11.04±1.98)fL vs.(12.83±2.38)fL]较治疗前下降(t=3.409、3.613,均P<0.05),差异均有统计学意义。ROC曲线分析显示,PC、PDW、MPV、PCT对诊断儿童ITP具有较高的敏感度(100.0%、48.7%、89.7%、97.4%)和特异度(100.0%、92.3%、87.2%、94.9%)。对照组、ITP患儿组及包虫病患儿组间PC、PDW、MPV和PCT水平差异均有统计学意义(F=410.991、18.510、86.718、217.536,P均<0.001)。其中,ITP患儿组PC、PCT较对照组低,PDW、MPV较对照组高,差异均有统计学意义(P均<0.05)。包虫病患儿组PC、PCT均较对照组和ITP患儿组高,PDW、MPV较ITP患儿组低,差异均有统计学意义(P均<0.05)。结论血小板参数对儿童ITP的诊断具有重要意义,且正常儿童、ITP患儿、包虫病患儿间血小板参数各指标存在差异。
Objective To investigate the application of platelet parameters in the diagnosis of immune thrombocytopenia(ITP)in children and analyze the difference between normal children,children with ITP and children with echinococcosis.Methods Thirty-nine children with ITP and 39 children with hydatid disease admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2019 to October 2022 were selected as the observation group.78 children who underwent a physical examination during the same period were selected as the control group.The correlation between platelet parameters[platelst count(PC),platelet distribution width(PDW),mean platelet volume(MPV),thrombocytocrit(PCT)]in children with ITP at initial diagnosis and the correlation between each index and age were analyzed.The platelet parameters in children with ITP before and after treatment were compared,and the diagnostic value of platelet parameters in ITP was analyzed by receiver operating characteristic(ROC)curve.Finally,the differences of platelet parameters in normal children,children with ITP and children with echinococcosis were analyzed.Results There was a significant positive correlation between PC and PCT(r=0.959,P<0.05),and a significant positive correlation between PDW and MVP(r=0.933,P<0.05).There was no significant correlation between the parameters and the age of the children.After treatment,PC[(154.44±84.31)×10^(9)/L vs.(36.20±34.12)×10^(9)/L]and PCT[(0.16±0.08)%vs.(0.04±0.04)%]in ITP group were higher than those before treatment(t=8.117,8.046;all P<0.05),and PDW[(13.07±4.40)fL vs.(16.90±5.48)fL]and MPV[(11.04±1.98)fL vs.(12.83±2.38)fL]were lower than those before treatment(t=3.409,3.613;all P<0.05).ROC curve analysis showed that PC,PDW,MPV and PCT had high sensitivity(100.0%,48.7%,89.7%,97.4%)and specificity(100.0%,92.3%,87.2%,94.9%)in the diagnosis of ITP in children.PC and PCT in children with ITP were lower than those in normal chiedren(all P<0.05),PDW and MPV were higher than those in normal children(all P<0.05).PC and PCT in children with echinococcosis were higher than those in normal children(all P<0.05).PC and PCT in children with echinococcosis were higher than those in children with ITP(all P<0.05),PDW and MPV were lower than those in children with ITP(all P<0.05),the differences were statistically significant.Conclusion Platelet parameters were of great significance for the diagnosis of ITP in children,and there were differences in platelet parameters among normal children,children with ITP and children with echinococcosis.
作者
马嘉欣
刘玉
赵莉
岳迎宾
严媚
MA Jiaxin;LIU Yu;ZHAO Li;YUE Yingbin;YAN Mei(Pediatric Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)
出处
《热带医学杂志》
CAS
2023年第10期1382-1385,1391,共5页
Journal of Tropical Medicine
基金
国家自然科学基金(82160031,81830066)
新疆维吾尔自治区天山创新团队计划(2020D14027)
省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2021-JH3)
