血小板计数和血小板指数在评估儿童炎症性肠病活动性中的诊断价值

E. Semikina, V. Tsvetkova, A. Potapov, A. Fisenko, E. A. Kopyl'tsova, S. Akulova, A. Surkov, M. Lokhmatov, T. N. Budkina, M. Vershinina
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The study included platelet indices of 630 complete blood count tests (270 in patients with CD and 360 in patients with UC): platelet count (PLT), mean platelet volume (MPV), platelet large cell ratio (P-LCR) and platelet distribution width (PDW). Results. Increased platelet count and decreased platelet indices were noted as the clinical and endoscopic activity of CD and UC in children increased. A positive correlation between the clinical and endoscopic activity indices in inflammatory bowel diseases and platelet count and negative correlations with platelet indices were revealed. ROC analysis showed that the informative value of platelet indices in assessing the endoscopic activity of CD and UC is higher than in assessing the clinical activity. The optimal threshold values for platelet count (cut-off) for determining the endoscopic activity of CD and UC were 340 × 109/L and 350 × 109/L (Se 77%, Sp 69% and Se 63%, Sp 67%, respectively). The specificity of determing the endoscopic activity of 99% was obtained for platelet count of 459 × 109/L and 390 × 109/L for CD and UC, respectively. In children with CD, the indicators MPV <7.8 fL, PDW <7.25 fL, P-LCR <15.2% characterized the presence of endoscopic disease activity with 99% specificity; in children with UC, the specificity of determining the endoscopic activity of 99% was obtained for MPV <9.25 fL, PDW <9.85 fL, P-LCR <17.5%. Conclusion. An increase in platelet count and a decrease in platelet indices (MPV, PDW and P-LCR) can be surrogate markers of endoscopic activity of these diseases. The established threshold values will improve the accuracy of diagnosing the activity of inflammatory bowel diseases in children. 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引用次数: 0

摘要

目标。分析全血细胞计数试验中血小板指数复合体与儿科患者克罗恩病(CD)和溃疡性结肠炎(UC)的临床和内镜活动性评分之间的关系,并确定其最具信息量的阈值。患者和方法。在这项研究中,370名5至18岁的诊断为CD (n = 150)和UC (n = 220)的儿童进行了检查。UC临床活动性按PUCAI评估,CD -按PCDAI评估;根据UCEIS和CD -根据SES-CD对UC患儿的内镜活动进行评估。研究包括630项全血细胞计数(CD患者270项,UC患者360项)的血小板指标:血小板计数(PLT)、平均血小板体积(MPV)、血小板大细胞比(P-LCR)和血小板分布宽度(PDW)。结果。随着儿童CD和UC的临床和内镜活动的增加,血小板计数增加,血小板指数下降。炎症性肠病的临床和内镜活动指数与血小板计数呈正相关,与血小板指数呈负相关。ROC分析显示,血小板指数在评估CD和UC的内镜活动性方面的信息价值高于评估临床活动性。用于判断CD和UC内镜下活动性的血小板计数最佳阈值(截止值)分别为340 × 109/L和350 × 109/L (Se为77%,Sp为69%,Se为63%,Sp为67%)。对于血小板计数分别为459 × 109/L和390 × 109/L的CD和UC,确定内镜下活性的特异性为99%。在CD患儿中,MPV <7.8 fL, PDW <7.25 fL, P-LCR <15.2%表征内镜下疾病活动性,特异性为99%;在UC患儿中,当MPV <9.25 fL, PDW <9.85 fL, P-LCR <17.5%时,确定内镜下活动的特异性为99%。结论。血小板计数的增加和血小板指数(MPV、PDW和P-LCR)的下降可以作为这些疾病内镜下活动的替代标志物。建立的阈值将提高诊断儿童炎症性肠病活动性的准确性。关键词:克罗恩病,溃疡性结肠炎,血小板,血小板指数,临床活动性,内镜活动性
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Diagnostic value of platelet count and platelet indices in assessing inflammatory bowel disease activity in children
Objective. To analyze the connection between the complex of platelet indices in complete blood count test with the clinical and endoscopic activity scores for Crohn's disease (CD) and ulcerative colitis (UC) in pediatric patients and to determine their most informative threshold values. Patients and methods. In this study, 370 children aged 5 to 18 years with diagnosed CD (n = 150) and UC (n = 220) were examined. The clinical activity of UC was assessed according to PUCAI, CD – according to PCDAI; the assessment of endoscopic activity in children with UC was carried out according to UCEIS and CD – according to SES-CD. The study included platelet indices of 630 complete blood count tests (270 in patients with CD and 360 in patients with UC): platelet count (PLT), mean platelet volume (MPV), platelet large cell ratio (P-LCR) and platelet distribution width (PDW). Results. Increased platelet count and decreased platelet indices were noted as the clinical and endoscopic activity of CD and UC in children increased. A positive correlation between the clinical and endoscopic activity indices in inflammatory bowel diseases and platelet count and negative correlations with platelet indices were revealed. ROC analysis showed that the informative value of platelet indices in assessing the endoscopic activity of CD and UC is higher than in assessing the clinical activity. The optimal threshold values for platelet count (cut-off) for determining the endoscopic activity of CD and UC were 340 × 109/L and 350 × 109/L (Se 77%, Sp 69% and Se 63%, Sp 67%, respectively). The specificity of determing the endoscopic activity of 99% was obtained for platelet count of 459 × 109/L and 390 × 109/L for CD and UC, respectively. In children with CD, the indicators MPV <7.8 fL, PDW <7.25 fL, P-LCR <15.2% characterized the presence of endoscopic disease activity with 99% specificity; in children with UC, the specificity of determining the endoscopic activity of 99% was obtained for MPV <9.25 fL, PDW <9.85 fL, P-LCR <17.5%. Conclusion. An increase in platelet count and a decrease in platelet indices (MPV, PDW and P-LCR) can be surrogate markers of endoscopic activity of these diseases. The established threshold values will improve the accuracy of diagnosing the activity of inflammatory bowel diseases in children. Key words: Crohn's disease, ulcerative colitis, platelets, platelet indices, clinical activity, endoscopic activity
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来源期刊
Voprosy Detskoi Dietologii
Voprosy Detskoi Dietologii Medicine-Pediatrics, Perinatology and Child Health
CiteScore
1.20
自引率
0.00%
发文量
17
期刊介绍: The scientific journal Voprosy Detskoi Dietologii is included in the Scopus database. Publisher country is RU. The main subject areas of published articles are Food Science, Pediatrics, Perinatology, and Child Health, Nutrition and Dietetics, Клиническая медицина.
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