MPV、PDW、P-LCC等参数联合检测在儿童免疫性血小板减少性紫癜中的诊断价值

Diagnostic value of MPV,PDW and P-LCC and other parameters combined detection in children with immune thrombocytopenic purpura

目的探讨血小板(PLT)、平均血小板体积(MPV)、血小板体积分布宽度(PDW)、大血小板比率(P-LCR)、大血小板数目(P-LCC)、白细胞(WBC)联合检测在儿童免疫性血小板减少性紫癜(ITP)早期诊断和疗效监测中的价值。方法选取儿童ITP患儿63例作为试验组,其中轻度组7例、中度组15例、重度组13例和极重度组28例,另选取同期进行体检的65例健康儿童作为对照组。应用Mindray BC-6800全自动血细胞分析仪对两组PLT、MPV、PDW、P-LCR、P-LCC和WBC等参数进行检测和统计分析;利用二元Logistic回归模型进行多因素分析,通过绘制受试者工作特征曲线(ROC曲线)评估上述指标及其联合检测对ITP骨髓巨核细胞成熟障碍的诊断价值。结果与对照组比较,试验组PLT、P-LCC降低,PDW减小,而MPV、P-LCR和WBC升高(P<0.05);P-LCC在随着病情严重度增高而显著降低(P<0.05);采用Logistic回归模型进行多因素ROC曲线分析,结果显示单项指标P-LCC诊断儿童ITP的灵敏度最高,为95.6%,MPV+PDW+WBC+P-LCR+P-LCC联合检测的灵敏度和特异度分别为98.5%和92.9%,较单项指标明显增加。结论MPV、PDW、WBC、P-LCR、P-LCC联合检测能够提高对儿童ITP的诊断价值。

Objective To investigate the value of combined detection of platelet(PLT),mean platelet volume(MPV),platelet distribution width(PDW),large platelet ratio(P-LCR),platelet-large cell count(P-LCC),white blood cell(WBC)in the early diagnosis and efficacy monitoring for children with immune thrombocytopenic purpura(ITP).Methods A total of 63 children with ITP were selected as the experimental group,including 7 cases with mild disease group,15 cases with moderate disease group,13 cases with severe disease group and 28 cases with extremely severe disease group,and another 65 healthy people who underwent physical examination during the same period were selected as the control group.The PLT,MPV,PDW,P-LCR,P-LCC and WBC and other parameters in the two groups were detected and statistically analyzed by the Mindray BC-6800 automatic blood cell analyzer.The binary Logistic regression model was used for multivariate analysis,and the receiver operating characteristic curve(ROC curve)was drawn to evaluate the diagnostic value of the above indexes and their combined detection for ITP.Results Compared with the control group,the results of PLT,P-LCC and PDW in the experimental group were decreased,while the results of MPV,P-LCR and WBC were increased,and the differences were statistically significant(P<0.05).P-LCC was significantly decreased with the severity increase of the disease(P<0.05).Logistic regression model was used for multivariate ROC curve analysis,and the results showed that P-LCC had the highest sensitivity of 95.6%in the diagnosis of children with ITP.The sensitivity and specificity of MPV+PDW+WBC+P-LCR+P-LCC were respectively 98.5%and 92.9%,which were significantly higher than those of the single detection.Conclusion The combined detection of MPV,PDW,WBC,P-LCR,P-LCC can improve the diagnostic value of children with ITP.