摘要
目的:探讨血小板参数对过敏性紫癜(HSP)及其消化道出血的临床诊断和预测价值。方法:收集确诊为HSP的患儿201例,其中消化道出血28例,无消化道出血173例,以同时期健康儿童100例为对照组。检测各组血小板(PLT)计数、淋巴细胞(LYM)计数、平均血小板体积(MPV)、血小板分布宽度(PDW),计算血小板与淋巴细胞比值(PLR),并分析HSP患儿血小板参数间的Spearman相关性。通过ROC曲线评价血小板参数对HSP及其消化道出血的临床诊断和预测价值。结果:MPV与PDW存在正向的强相关关系,LYM与PLR存在负向的强相关关系; PLT与PLR存在正向的中度相关关系,PLT与MPV存在负向的中度相关关系(分别rs=0. 876、-0. 755、0. 394、-0. 303,P <0. 01)。HSP组的PLT、PLR、PDW较对照组升高,LYM较对照组降低,差异有统计学意义(P <0. 05)。其中PLR的ROC曲线下面积(AUC)为0. 771,最佳cut-off值为104. 87,敏感度58. 7%,特异性88. 0%,阳性预测值(PPV) 90. 8%,阴性预测值(NPV) 51. 5%。LYM的AUC为0. 733,最佳cut-off值为2. 79×109/L,敏感度49. 3%,特异性90. 0%,PPV 90. 8%,NPV46. 9%。消化道出血组PLR较无出血组升高(P <0. 05),PLR的AUC为0. 629,最佳cut-off值为122. 30,敏感度64. 3%,特异性64. 2%,PPV:22. 5%,NPV:91. 7%。结论:PLR和LYM对HSP有一定的诊断价值,且PLR的诊断准确度较LYM高。PLR对HSP患儿消化道出血也有一定预测价值。
Objective To explore the value of platelet parameters in diagnosis and prediction of Henoch - Schonlein purpura （HSP） and its gastrointestinal bleeding. Method A total of 201 children diagnosed with HSP were included in the HSP group, a- mong whom 28 had gastrointestinal bleeding and 173 had no gastrointestinal bleeding. 100 healthy children in the same period were taken as control group. The platelet （PLT） count,lymphocyte （LYM） count,mean platelet volume （MPV）, platelet distri- bution width （PDW） and platelet -lymphocyte ratio （PLR） were measured, and the Spearman correlation among them were ana- lyzed. Evaluation of the clinical diagnostic and predictive value of platelet parameters to HSP and its gastrointestinal bleeding by ROC curve. Results A positive strong correlation between MPV and PDW,a negative strong correlation between LYM and PLR; a positive moderate correlation between PLT and PLR, a negative moderate correlation between PLT and MPV （rs = 0. 876, - 0. 755,0. 394, -0. 303,P 〈 0. 01 ）. The levels of PLT, PLR, PDW in HSP group were higher than those in control group, LYM decreased compared with control group （P 〈 0. 05 ）. The area under the Roe curve （AUC） of PLR was 0. 771, the best cut -off value was 104. 87, sensitivity ： 58.7% , specificity ： 88.0% , positive predictive value （ PPV ） ： 90. 8% , negative predictive value （NPV） ：51.5%. The AUC of LYM was 0. 733, the best cut - off value was 2. 79 x 109/L, sensitiviu：49. 3% , specificity： 90. 0% ,PPV ：90. 8% ,NPV ：46.9%. PLR in gastrointestinal bleeding group was higher than that in non - bleeding group （ P 〈 0. 05 ）, The AUC of PLR was 0. 629, the best cut - off value was 122. 30, sensitivity ： 64. 3 %, specificity ： 64. 2 % , PPV ： 22.5 % , NPV ：91.7%. Conclusion PLR and LYM have certain diagnostic value to HSP, and the diagnostic accuracy of PLR is higher than that of LYM. PLR also had a certain predictive value for gastrointestinal bleeding in HSP children.
作者
张慧
南虎松
ZHANG Hui;NAN Hu-Song(Department of Pediatrics,Affiliated Hospital of Yanbian University,Yanji 133000,China)
出处
《吉林医学》
CAS
2018年第10期1836-1840,共5页
Jilin Medical Journal
关键词
过敏性紫癜
消化道出血
血小板参数
ROC曲线
儿童
Henoch - Schonlein purpura
Gastrointestinal bleeding
Platelet parameters
ROC curve
Child
