血小板、平均血小板容积及红细胞分布宽度在活动性克罗恩病和肠结核患者中的诊断价值

The significance of platelet count,mean platelet volume and red cell distribution width in diagnosis of active Crohn's disease and intestinal tuberculosis

目的评估血小板和平均血小板容积及红细胞分布宽度在活动性克罗恩病患者和肠结核患者相对肠易激综合征的诊断价值。方法选取重庆市大足区人民医院纳入的68例活动期克罗恩病(CD)患者,35例肠结核(ITB)患者和22例肠易激综合征(IBS)患者。血常规检查包括白细胞(WBC)、红细胞(RBC)、血小板(PLT)、平均血小板容积(RDW)、红细胞分布宽度(MPV)等。结果相比IBS患者,活动期CD患者和ITB患者其白蛋白(ALB)和平均血小板容积水平较低(P<0.05),白细胞计数、血小板计数和红细胞分别宽度升高(P<0.05),在活动期CD和ITB患者中,PLT正相关于ESR和负相关于MPV(P<0.05)。血小板在活动期CD患者相关于白蛋白,而其在ITB患者中相关于C-反应蛋白和红细胞(P<0.05)。MPV相关于PLT在CD和ITB患者中,而在ITB患者中MPV则相关于WBC。RDW(OR=2.390和OR=2.338)在预测活动性CD和ITB中相比CRP(OR=1.025和OR=1.013)和ESR(OR=1.157和OR=1.192)有着较高的价值。PLT(AUC=0.848)相比CRP(AUC=0.691)和ESR(AUC=0.844)诊断价值相当。PLT联合RDW的约登指数高于CRP。这些指标在鉴别活动期CD和ITB中差异无统计学意义(P>0.05)。结论 PLT、MPV和RDW在活动期CD和ITB患者中与IBS比较,差异有统计学意义(P<0.05),并且其在诊断活动期CD和ITB中具有一定的诊断价值。

Objective To evaluate the diagnostic value of platelet count,mean platelet volume and red cell distribution width in patients with active Crohn’s disease(CD)and intestinal tuberculosis(ITB),as compared with that in irritable bowel syndrome(IBS).Methods Sixty-eight patients with active CD,35 patients with intestinal tuberculosis and 22 patients with irritable bowel syndrome were enrolled in the study.Blood routine tests were performed including white blood cell,red blood cell,platelet(PLT)count,mean platelet volume(MPV),red cell distribution width(RDW).Results As compared with those in patients with IBS,the levels of albumin(ALB)and MPV in patients with active CD and patients with ITB were significantly decreased(P<0.05),however,white blood cell count,platelet count and RDW were obviously increased(P<0.05).In patients with active CD and patients with ITB,PLT was positively correlated to ESR,however,which was negatively related with MPV(P<0.05).The platelet count in active CD patients was closely correlated to ALB,however,which in ITB patients was closely related with C-reactive protein and red blood cells(P<0.05).MPV was correlated to PLT in active CD patients and ITB patients,but in ITB patients,MPV was associated with WBC.The RDW(OR=2.390 or OR=2.338)was superior to CRP(OR=1.025 and OR=1.013)and to ESR(OR=1.157 and OR=1.192)in prediction of active CD and ITB.The diagnostic significance of PLT(AUC=0.848)was similar to that of CRP(AUC=0.691)and ESR(AUC=0.844).The Youden index of PLT combined with RDW was higher than that of CRP.However there were no significant differences in these parameters in distinguishing active CD from ITB(P>0.05).Conclusion In the diagnosis of active CD and ITB,the PLT,MPV,RDW has certain diagnostic value by single detection or combination detection for there are significant differences in the levels of PLT,MPV and RCDW between active CD patients and ITB patients as well as IBS patients.