摘要
目的 研究ITP-BAT出血评分系统在原发免疫性血小板减少症(ITP)的临床应用价值.方法 采用ITP-BAT出血评分系统对183例ITP患者进行出血评分及出血严重程度分级,分析ITP患者出血评分与血小板计数、年龄、性别、疾病分期的关系以及ITP-BAT出血评分系统的反应度、重测可信度.结果 ITP患者出血程度与血小板计数呈负相关(r=-0.744,P<0.01),PLT≤20×109/L时,患者出血程度加重(χ^2=82.40,P<0.01).儿童患者轻度出血占68.4%(26/38),与其他年龄组比较差异有统计学意义(χ^2=8.839,P<0.01).年龄≥60岁老年患者严重出血占老年患者14.3%(3/21),与其他年龄组比较差异有统计学意义(χ^2=7.056,P<0.01).性别和疾病分期在出血程度上差异无统计学意义(χ^2=4.922,P>0.05;χ^2=3.411,P>0.05).ITP患者治疗前后出血评分差异具有统计学意义(Z=-6.61,P<0.01).两名医师评分结果完全相同的比例为66.1%(κ=0.561),同一名医师两次评分结果完全相同的比例为94.7%(κ=0.874).结论 ITP-BAT出血评分系统在中国ITP患者中有很好的效度和反应度,与临床指标密切相关,能敏感地反映患者出血症状的变化,可以作为治疗的参考指标和疗效的观察指标.
Objective To explore the clinical significance,reliability and responsiveness of ITP-BAT bleeding grading system for patients with immune thrombocytopenia(ITP).Methods One hundred and eighty-three patients with ITP were assessed by using of ITP-BAT bleeding grading system.Test-retest reliability,responsiveness of ITP-BAT bleeding grading system and association between bleeding grades and platelet counts,age,gender,disease stage were analyzed.Results Bleeding degree of ITP patients and the platelet count were negatively correlated (r=-0.744,P〈0.01) and bleeding degree increased significantly with platelet counts below 20 × 109/L (χ^2=82.40,P〈0.01).Mild bleeding rate in children was 68.5%,higher than that in adult (χ^2=8.839,P〈0.01),and severe bleeding rate in the elderly was 14.3%,higher than that in non-elderly (χ^2=7.056,P〈0.01).There were no significant differences in bleeding degree in patients with different gender and disease stage (χ^2=4.922,P〉0.05 and χ^2=3.411,P〉0.05).Bleeding grades before and after treatment had more significant difference (Z=-6.61,P〈0.01).Scoring consistency of two doctors was 66.1% (κ=0.561),and scoring consistency of the same doctor was 94.7% (κ=0.874).Conclusions ITP-BAT bleeding grading system in China has good validity and responsiveness,closely related to clinical indicators.It is sensitive to the variation of the hemorrhage in patients.ITP-BAT could be used as a reference index of the treatment,and also be used as an observation index of curative effect.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2014年第9期812-815,共4页
Chinese Journal of Hematology
基金
国家自然科学基金(81070397、81270581)
科技部重大血液病新药临床评价研究技术平台体系建设(2011ZX 09302-007-04)
卫生公益性行业科研专项(201202017)