血小板参数在肾综合征出血热与过敏性紫癜鉴别诊断中的应用研究

陶际春; 范冬青; 余晚凤; 盛淼佳; 朱梦怡; 刘舒琦; 杨进孙; 孙恩涛

doi:10.13898/j.cnki.issn.1000-2200.2023.06.020

血小板参数在肾综合征出血热与过敏性紫癜鉴别诊断中的应用研究

Application of platelet parameters in antidiastole between hemorrhagic fever with renal syndrome and Henoch-Schönlein purpura

摘要

摘要:
目的通过分析肾综合征出血热(hemorrhagic fever with renal syndrome，HFRS)和过敏性紫癜(Henoch-Schönlein purpura，HSP)的血小板参数，探讨其在HFRS与HSP的鉴别诊断中的应用价值。
方法收集皖南医学院弋矶山医院2016-2021年就诊并确诊的HFRS病人和HSP病人的血常规中血小板相关的检验结果。比较2组病人血常规中血小板平均体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)、血小板计数(PLT)均值，并对以上指标用于HFRS与HSP的鉴别诊断的应用价值进行logistic回归分析和ROC分析。
结果与HSP组病人相比，HFRS组病人的PDW和MPV明显升高(P < 0.01和P < 0.05)，PLT和PCT明显降低(P < 0.01)。logistic回归模型在调整了性别和年龄后，PLT偏高和正常者较PLT偏低者发生HFRS的风险明显降低(P < 0.01)。PLT用于HFRS与HSP鉴别诊断的ROC曲线的AUC=0.956，约登指数为0.838，cut-off值为128.50×10⁹/L。
结论与HSP病人相比，HFRS病人在就诊时第一次血常规中血小板参数的特点为PDW和MPV明显升高，而PLT和PCT明显降低，病人的PLT低于正常参考范围时更可能患有HFRS，PLT < 128.50×10⁹/L可作为HFRS与HSP的鉴别诊断指标。

Abstract:
ObjectiveTo explore the value of platelet parameters in antidiastole between hemorrhagic fever with renal syndrome (HFRS) and Henoch-Schönlein purpura (HSP) by analyzing platelet parameters of patients with HFRS and HSP.
MethodsThe platelet parameters of patients diagnosed with HFRS (HFRS group) or HSP (HSP group) in Yijishan Hospital of Wannan Medical College from January 2016 to December 2021 were gathered.The statistical difference of the parameters of platelet parameters such as MPV, PCT, PDW and PLT between the HFRS group and HSP group were analyzed.The value of platelet parameters in antidiastole between HFRS and HSP were appraised through logistic regression and ROC analysis.
ResultsCompared with the HSP group, the MPV and PDW in HFRS group were significantly increased (P < 0.01 and P < 0.05), and the PLT and PCT were significantly decreased (P < 0.01).Logistic regression model adjusted for gender and age, the risk of HFRS in those with higher and normal PLT was significantly lower than that in those with lower PLT (P < 0.01).The AUC of ROC curve of PLT in antidiastole between HFRS and HSP was 0.956, Yoden index was 0.838, and cut-off value was 128.5×10⁹/L.
ConclusionsCompared with HSP patients, the features of platelet parameters of the initial test of blood routine of HFRS patients are as follows: the MPV and PDW are significantly increased, and the PLT and PCT are significantly decreased.Patients with PLT lower than the reference range have higher probability of HFRS, PLT < 128.5×10⁹/L can be used as a marker in antidiastole between HFRS and HSP.

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