活动性与非活动性肺结核血小板参数、D-D检测的临床意义

Clinical significance of platelet parameters and D-D detection for patients with active and non-active tuberculosis

目的分析活动性与非活动性肺结核患者血小板参数及D-二聚体(D-D)检测的临床价值。方法以我院收治的80例活动性、非活动性肺结核患者作为研究对象,其中活动性肺结核38例(活动组),非活动性肺结核42例(非活动组),同时选取正常健康人45例作为对照组,分别测定3组的血小板参数和D-D水平,并行统计学分析。结果 (1)治疗前,活动组血小板计数(PLT)、平均血小板容积(MPV)、D-D均高于对照组和非活动性组(P<0.05),非活动组PLT、MPV、D-D高于对照组(P<0.05);(2)治疗后,活动组、非活动组血小板参数及D-D水平均趋向正常,两组PLT、MPV、血小板分布宽度(PDW)、大血小板比率(P-LCR)对比无统计学差异(P>0.05),但活动组D-D高于非活动组(P<0.05);(3)治疗3个月后,活动组血栓事件发生率为21.05%,高于非活动组的4.76%(P<0.05)。结论肺结核患者血清PLT、MPV、D-D均高于正常健康人,以活动性肺结核增高更明显,血栓事件发生率更高,可将PLT、MPV、D-D水平的变化作为肺结核患者发生血栓事件的预测指标。

Objective To explore the clinical significance of platelet parameters and D-dimer （D-D） detection of patients with active and non-active tuberculosis. Methods A total of 80 patients who had been suffering active or non-active tuberculosis and had been admitted by the hospital were selected and divided into an active group（n=38） and a non-active group（n=42）; besides, 45 healthy people were selected to constitute a control group. Platelet parameters and D-D levels in three groups were separately determined and subject to statistical analyses. Results （1） Before the treatment, platelet count （PLT）, mean platelet volume （MPV） and D-D of the active group were higher than those in the control and non-active groups （P 〈 0.05）, whereas PLT, MPV and D-D of the non-active group were higher than the control group （P 〈 0.05）. （2） After the treatment, platelet parameters and D-D levels of both active and non-active groups tended to be normal, and there were no statistical differences observed in PLT, MPV, platelet distribution width and platelet large cell ratio（P-LCR） between the two groups（P 〉 0.05）. However, the D-D level of the active group was higher than that in the non-active group （P 〈 0.05）. （3） After three months treatment, the incidence of thrombotic complications in the active group was 21.05%, higher than that in the non-active group 4.76%（P 〈 0.05）. Conclusion PLT, MPV and D-D level in serum of patients of tuberculosis are higher than healthy people, which are especially high for active tuberculosis which usually result in higher rate of incidence of thrombotic complications. Therefore, PLT, MPV and D-D level may be regarded as forecasting indicators for thrombotic complications of tuberculosis.