摘要
目的探讨急性胰腺炎(AP)时血小板计数的变化规律及其临床意义。方法回顾性分析AP不同病程、严重程度、性别、年龄的血小板计数变化的特点。结果AP发病第1天中有49%的患者血小板计数<100×109/L,该比例随后逐渐下降(r=-0.85);平均血小板计数在起病的前2周内呈上升趋势(r=0.96),且不同发病天数间的平均血小板计数有显著差异(P<0.01)。病程中后期,部分患者的血小板计数>300×109/L,其比例随病程时间延长而升高(r=0.83);上述变化在不同性别中无明显差异,但≥60岁的患者中血小板计数<100×109/L的比例明显高于<60岁者(P<0.05)。重症胰腺炎(SAP)患者发病前3天首次血小板计数<100×109/L的比例(57%)明显多于轻症AP患者(19%,P<0.001),病程中血小板计数>300×109/L的比例(29%)也明显多于轻症患者(7%,P<0.001)。如以发病后首次血小板计数<100×109/L为标准预测SAP,其敏感性59%,特异性81%,阳性预测值51%,阴性预测值85%。结论AP发病时血小板计数有下降趋势,随着病程延长,血小板计数有增高趋势,血小板计数<100×109/L对预测SAP有较高的特异性。
Objective To study the change of platelet counts and the clinical significance of the change in the patients with acute pancreatitis (AP). Methods Four handred and twenty five platelet records of 202 patients with AP were retrospectively reviewed, and the change of platelet counts and the clinical significance of the change were studied. Results There were 49% of patients with AP whose platelet counts were lesser than 100 × 109/L in the first day of the attack, and the proportion decreased day by day until the end of the second week ( r = - 0. 849, P < 0. 01). The proportion was higher in severe patients than that in mild ones. The mean platelet count gradually increased in the first two weeks of the disease( r = 0. 961, P < 0. 001) . Some patients' platelet counts were > 300 × 109/L during middle-later period of the attack and the proportion gradually increased( r = 0.829, P < 0.05). If platelet counts < 100 × 109/L serves as the severe index, the sensibility is 59%, specificity 81%, positive predictive value 51%, and negative predictive value 85% . Conclusion AP patients' platelet counts decrease at the beginning of the disease and the counts gradually increase until the end of the second week. As a severe index, there is highly specificity while platelet counts < 100 × 109/L.
出处
《苏州大学学报（医学版）》
CAS
北大核心
2005年第1期107-109,共3页
Suzhou University Journal of Medical Science
