血小板相关参数对评估炎症性肠病活动性的临床意义

Clinical significance of platelet-related parameters in evaluating the activity of inflammatory bowel disease

目的探讨血小板相关参数评估炎症性肠病(IBD)活动性的价值。方法回顾性收集2010年1月至2019年6月九江学院附属医院消化内科住院的溃疡性结肠炎(UC)及克罗恩病(CD)患者共206例,另选取于九江学院附属医院健康体检50例健康人员作为对照;收集研究对象临床资料,并依据病史、Myao活动指数、蒙特利尔分级及克罗恩病活动指数(CDAI)对患者进行分组及疾病严重程度分级。收集患者首次诊断时的血常规检测指标。结果IBD患者的血小板相关参数除P-LCR外与对照组比较均有明显差异(P<0.05);CD患者PCT及PLT显著高于UC(P分别0.007、<0.001);IBD活动期患者血小板参数与对照组存在显著差异(P<0.05);且UC患者病情与血小板参数存在相关性,重度患者PLT高于轻度患者(P<0.05)、MPV低于轻度患者(P=0.001);将MPV、PDW、P-LCR、PCT、PLT联合诊断IBD的活动性,得到AUC=0.857,95%CI 0.803~0.912,P<0.05。结论MPV、PDW在IBD活动期降低;PLT、PCT则增高;血小板相关参数联合诊断可较好反映IBD活动性。

Objective To investigate the value of platelet-related parameters in evaluating the activity of inflammatory bowel disease(IBD).Methods A total of 206 patients with ulcerative colitis(UC)and Crohn's disease(CD)who were hospitalized in the Department of Gastroenterology of the Affiliated Hospital of Jiujiang College from January 2010 to June 2019 were retrospectively collected,and another 50 healthy people were selected as controls;The clinical data of the study subjects were used to classify patients according to medical history,Myao activity index,Montreal classification,and Crohn's disease activity index(CDAI)and classify disease severity.Collect the blood routine detection indexes of the patients at the first diagnosis.Results Except for P-LCR,the platelet-related index of patients with IBD was significantly different from that the control group(P<0.05);PCT and PLT in CD patients were significantly higher than those in UC(P 0.007,<0.001 respectively);There were significant differences in the control group(P<0.05);and the condition of UC patients was correlated with platelet parameters.PLT in severe patients was higher than that in mild patients(P<0.05)and MPV was lower than that in mild patients(P=0.001).,PDW,P-LCR,PCT,PLT combined diagnosis of IBD activity,the AUC=0.857,95%CI 0.803-0.912,P<0.05.Conclusion MPV and PDW decreased during IBD active period;PLT and PCT increased;combined diagnosis of platelet-related parameters can better reflect IBD activity.