ABSTRACT
Abstract Objective The availability of reliable and inexpensive markers that can be used to determine the risk of rupture during methotrexate (MTX) treatment in ectopic pregnancies (EPs) is considerable. The aim of the present study is to investigate the role of systemic inflammatory markers such as leukocytes (or white blood cells, WBCs), the neutrophil-to-lymphocyte ratio (NLR), and platelet distribution width (PDW), which are among the parameters of the complete blood count (CBC), in the prediction of rupture of EPs under MTX treatment. Materials and Methods A total of 161 patients with tubal EP who underwent a single-dose methotrexate (MTX) protocol were retrospectively analyzed, and the control group (n = 83) included patients cured by MTX, while the ruptured group (n = 78) included patients who were operated on for tubal rupture during the MTX treatment. The features of EP, beta-human chorionic gonadotropin (β-hCG) levels, sonographic findings, and CBC-derived markers such as WBC, NLR, and PDW, were investigated by comparing both groups. Results The NLR was found to be higher in the ruptured group, of 2.92 ± 0.86%, and significantly lower in the control group, of 2.09 ± 0.6%. Similarly, the PDW was higher (51 ± 9%) in the ruptured group, and it was significantly lower a (47 ± 13%) in the control group (p < 0.05). Other CBC parameters were similar in both groups (p > 0.05). Conclusion Systemic inflammation markers derived from CBC can be easily applied to predict the risk of tubal rupture in Eps, since the CBC is an inexpensive and easy-to-apply test, which is first requested from each patient during hospitalization.
Resumo Objetivo A disponibilidade de marcadores confiáveis e baratos que podem ser usados para determinar o risco de ruptura durante o tratamento com metotrexato (MTX) em gestações ectópicas (GEs) é considerável. O objetivo do presente estudo é investigar o papel de marcadores inflamatórios sistêmicos, como leucócitos (ou glóbulos brancos, glóbulos brancos), a relação neutrófilo-linfócito (NLR) e largura de distribuição de plaquetas (PDW), que estão entre os parâmetros do hemograma completo (hemograma), na predição de ruptura de PEs sob tratamento com MTX. Materiais e Métodos Foram analisados retrospectivamente 161 pacientes com EP tubária submetidas a protocolo de dose única de metotrexato (MTX), sendo que o grupo controle (n = 83) incluiu pacientes curadas com MTX, enquanto o grupo roto (n = 78) incluíram pacientes operadas por ruptura tubária durante o tratamento com MTX. As características de EP, beta-gonadotrofina coriônica humana (β-hCG), achados ultrassonográficos e marcadores derivados de CBC, como WBC, NLR e PDW, foram investigados comparando os dois grupos. Resultados A RNL foi maior no grupo roto, de 2,92 ± 0,86%, e significativamente menor no grupo controle, de 2,09 ± 0,6%. Da mesma forma, o PDW foi maior (51 ± 9%) no grupo roto, e foi significativamente menor a (47 ± 13%) no grupo controle (p < 0,05). Outros parâmetros do hemograma foram semelhantes em ambos os grupos (p > 0,05). Conclusão Marcadores inflamatórios sistêmicos derivados do hemograma podem ser facilmente aplicados para predizer o risco de ruptura tubária na Eps, uma vez que o hemograma é um exame de baixo custo e fácil aplicação, solicitado primeiramente a cada paciente durante a internação.
Subject(s)
Humans , Female , Pregnancy, Ectopic/drug therapy , Blood Platelets , Methotrexate/therapeutic useABSTRACT
【Objective】 To analyze the correlation between platelet distribution width (PDW) and hyperuricemia (HUA). 【Methods】 For this study we recruited 4 885 teaching and administrative staff of Xi’an Jiaotong University who took the physical examination in 2020 and met the requirements. The basic information, blood routine and serum biochemical index results were collected and analyzed retrospectively. Data were sorted by gender, and the serum UA level and the prevalence of HUA in different PDW quartiles were compared after dividing PDW into quartiles. The association of PDW with other indexes including age, serum biochemical indexes and blood routine indexes was analyzed. Then, the factors related to HUA in different genders were analyzed, and the independent influence of PDW on HUA was further analyzed. 【Results】 The serum UA level and prevalence of HUA were on the increase among different PDW quartiles both in two genders, and PDW level was positively correlated with serum UA level (P0.05). 【Conclusion】 PDW is correlated with HUA, and PDW may be an independent risk factor for HUA in males. However, further study is needed.
ABSTRACT
Introduction: Platelets are anucleated cytoplasmic fragments derived from megakaryocytes, they are oval in shape, 1 to 2 millimeters in diameter, and have a half-life of 8 to 10 days. MPV is measured by automated cell counters based on impedance and optical effect, and can be modified by the anticoagulant ethylene aminotetraacetic acid (EDTA), temperature and storage time of the sample; Therefore, it is recommended that the analysis of the sample and its reading be carried out ideally in the first hour after taking the sample and preferably in the first 30 min. Another concept that is important to include in the interpretation of platelet activity is platelet mass, which is defined as the relationship between the platelet count and MPV; from which it has been found that the inverse platelet count-MPV relationship is not linear, so several normograms have been described to evaluate this relationship.3,4 The number, density and size of platelets is determined by a complex interaction between growth factors, cytokines, hormones and the megakaryocyte in the bone marrow. Megakaryopoiesis is programmed to maintain platelet function and mass, a mechanism in which thrombopoietin, granulocyte colony-stimulating factor, interleukins 1 and 6, and tumor necrosis factor are closely involved. Thrombopoietin levels are determined by gender and the number of platelets. In situations of stress, platelet production and mass are increased, resulting in the release into the circulation of large numbers of large, highly reactive platelets that migrate to sites of injury. An intense stimulus at the medullary level induces a hyperproduction of platelets that is characterized by a high MPV.
ABSTRACT
Objective:To explore the correlation between platelet distribution width (PDW) and the stability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation.Methods:138 patients with persistent atrial fibrillation treated with warfarin in Jiujiang First People′s Hospital from January 2018 to December 2019 were selected. They were divided into groups according to whether PDW increased (PDW decreased group, normal group, PDW increased group) and subgroups stratification was performed. After stratification, the relationship between PDW and the stability of warfarin anticoagulation treatment [expressed as the percentage of time of International normalized ratio(INR) within the treatment target range (TTR)] was analyzed. At the same time, the predictive value of PDW for the stability of warfarin anticoagulation treatment was analyzed.Results:There were significant difference in PDW and TTR among the PDW decreased group, normal group, PDW increased group ( F=30.322, 10.745, all P<0.01). The PDW distribution of patients with different anticoagulation quality was significantly different (χ 2=9.532, P<0.05). Receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of PDW in predicting warfarin anticoagulant stability was 0.621(95% CI: 0.524-0.737). There was significant difference in PDW and TTR among the PDW<14%, 14%-<16%, 16-<18% and ≥18% groups( F=18.075, 11.638, all P<0.01). There was no significant difference in PDW and TTR among the three subgroups of PDW<14%, 14%-<16% and 16-<18% ( P=0.843, P=0.401). There were significant difference in PDW and TTR between the two subgroup of PDW 16-<18%、≥18% ( t=4.154, 6.712, all P<0.01). Conclusions:PDW is correlated with the standard rate of warfarin anticoagulant stability, and can be used to predict the standard rate of warfarin anticoagulant stability.
ABSTRACT
ABSTRACT Introduction: Smoking is associated with the occurrence and progression of cardiovascular diseases, inflammatory disorders and malignancies. Objective: To study the platelet indices, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in smokers and their correlation with smoking pack-years. Method: A total of 110 smokers and 110 non-smokers were included. The smokers were grouped into three groups: mild (<5 pack-years), moderate (5-10 pack-years) and heavy (>10 pack-years). The platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) were noted. The NLR and PLR were calculated and the statistical analysis was made using the Student's T-test, Analysis of Variance (ANOVA) and Spearman's correlation coefficient. Results: The platelet count, PCT and PDW were significantly higher with mean values: 218.56 ± 121.31 vs 203.23 ± 80.35 (p-value = 0.038), 0.27 ± 0.10 vs 0.26 ± 0.10 (p-value = 0.041) and 12.54 ± 1.45 vs 11.99 ± 1.70 (p-value = 0.001) in smokers and non-smokers, respectively. The PLR differed significantly with mean values: 119.40 ± 84.81 in smokers and 181.99 ± 313.09 in non-smokers, with a p-value of 0.045. A significant positive correlation was found between pack-years of smoking and platelet count and PLR with the Pearson correlation coefficient of 0.250 and 0.198 and p-values, 0.008 and 0.037, respectively. The Platelet Count, PCT, MPV and PDW varied significantly between mild, moderate and heavy smoker groups, with p-values of 0.045, 0.010, 0.015 and 0.017, respectively. Conclusion: The platelet indices and inflammatory markers NLR and PLR are derived from routine blood investigations, which are easily available and inexpensive. The monitoring of platelet indices, along with the PLR, can be used as early predictors of morbidity in smokers.
Subject(s)
Humans , Male , Female , Tobacco Use Disorder , Mean Platelet Volume , Thromboembolism , Lymphocytes , NLR Proteins , Heart Disease Risk Factors , NeutrophilsABSTRACT
Background:ISCHEMIC HEART DISEASES continues to be a major public health problem becoming an increasingly important problem in developing countries constitutes around 12.8% of total deaths (7.2 million).Objectives:To evaluate the clinical course of ACS patient’s admitted to KIMS HUBLI ICCU. Material & Methods:Patients admitting to ICCU KIMS, HUBLI diagnosed as Acute Coronary Syndrome.The study included 156 patients admitted to ICCU KIMS Hubli who diagnosed as ACUTE CORONORY SYNDROME. Results:There wassignificant difference in the platelet indices betweenthe three groups. The platelet Indices -mean platelet volume, platelet distribution width and platicrit were significantly higher in STEMI and NSTEMI groups when compared to the USA group and severity of CAD more in patients who were having higher platelet indices. Conclusion:The platelet indices: mean platelet volume (MPV), platelet distribution width (PDW) and platecrit are significantly higher in STEMI and NSTEMI groups when compared to USA group.
ABSTRACT
Abstract Objective To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. Methods A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. Results Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker. Conclusion The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.
Resumo Objetivo Descrever as alterações hematológicas, em particular os índices plaquetários em gestantes com doença coronavírus 2019 (COVID-19) em comparação com gestantes saudáveis. Métodos Estudo caso-controle retrospectivo realizado no Hospital Universitário Al Yarmouk, em Bagdá, Iraque envolvendo 100 gestantes, 50 com DNA viral positivo para COVID-19 (grupo caso) e 50 com resultados negativos (grupo controle); ambos os grupos foram submetidos a uma avaliação hematológica completa. Resultados Entre as principais variáveis hematológicas analisadas, os índices plaquetários, nomeadamente o volume plaquetário médio (VPM) e a largura de distribuição plaquetária (PDW), apresentaram diferenças estatisticamente significativas (VPM: 10,87±66,92 fL para o grupo caso versus 9,84±1.2 fL para o o grupo controle; PDW: 14,82±3,18 fL para o grupo caso versus 13,3±2,16 fL para os controles). O valor de critério da curva de característica de operação do receptor (ROC) para PDW em um ponto de corte de> 11,8 fL mostrou um marcador diagnóstico fraco, enquanto o do VPM emumvalor de corte de> 10,17 fL mostrou um bom marcador de diagnóstico. Conclusão OMPVe PDWsão significativamente afetados por esta infecção viral, mesmo em casos confirmados assintomáticos, e recomendamos que ambos os parâmetros sejam incluídos no painel de diagnóstico desta infecção.
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications, Infectious/blood , Blood Platelets/virology , COVID-19/blood , Pregnancy Complications, Infectious/diagnosis , Blood Platelets/physiology , Biomarkers/blood , Case-Control Studies , Retrospective Studies , Asymptomatic Diseases , Mean Platelet Volume , COVID-19 Testing , COVID-19/diagnosisABSTRACT
Endothelial cell dysfunction and inflammation are considered to have a role in the pathophysiology of pre-eclampsia(1).A generalized activation of circulating leukocytes (characteristic of inflammation) has been found during pre-eclampsia. Moreover, increased concentration of CRP and inflammatory markers has been reported in pre-eclampsia(2). We wanted to determine the serum CRP level in preeclampsia and assess the platelet dysfunction in pre-eclampsia and evaluate its association with severity of the disease. METHODSThe study was conducted at a tertiary care centre from November 2015 to August 2017. The study included a total of 200 singleton pregnant patients. After collecting basic demographic data and brief history, detailed clinical examination was carried out, routine investigations along with serum C - reactive protein were done. Results were recorded and maternal and foetal outcomes were noted. RESULTSAmong the 200 patients who were included in the study, it was found that majority of them were primigravidae. 88% of the patients showed increase in the C-reactive protein, which also correlated with the severity of the disease. Platelet count showed a decreasing trend with increasing severity of the disease and platelet distribution width showed an increasing trend with the increasing severity of the disease. CONCLUSIONSSerum C- reactive protein concentration increases in pre-eclampsia more than that compared to normal pregnancy. The serum C-reactive protein levels also helps in assessing the severity of the disease and its further prognosis. Further the abnormalities in platelet indices caused due to the disease process in pre-eclampsia is worsened due to thrombocytopenia. The morphological features of platelets as studied by Mean platelet volume and platelet distribution width are not consistent with the severity of the disease.
ABSTRACT
Background: Preeclampsia (PE) is a major cause of maternal and foetal morbidity and mortality in pregnancy. A decreased platelet count is observed during the progression of preeclampsia, and is considered a marker of the severity of preeclampsia. Considering the role of the PDW, PCT and platelet indices during the disease, the aim of this study was to evaluate the feasibility of using platelet indices as a severity marker for PE.Methods: This was a prospective, observational study, hospital-based study, from 2017-19 with 400 pregnant women being included on the basis of a predefined inclusion and exclusion criteria, through antenatal clinic, and labour room of the department of obstetrics and gynecology, S. C. B. Medical College, Cuttack, Odisha, India.Results: Study found that platelet count and plateletcrit showed a significant negative correlation with MAP whereas platelet distribution width showed a maximum positive correlation. In the preeclampsia group, subjects with PCT <0.22% were at risk of developing severe disease with a sensitivity of 53.5% and a high specificity of 85.5%. The AUC of 0.75 showed that it has a good predictability. In the eclampsia group, subjects with PCT <0.16% had a risk of developing severe disease with a sensitivity of 89.5% and specificity of 73.7%. The AUC 0.9 shows PCT to be a good predictor for assessing severity of eclampsia.Conclusions: This study suggests that platelet distribution width and plateletcrit are useful in risk evaluation of preeclampsia. These are a valid measurement tool to predict the severe progression of PE even when normal platelet counts are observed.
ABSTRACT
ObjectiveAt present, there are few studies on prognostic indicators for patients with severe traumatic brain injury (STBI). This paper aims to explore its significance by analyzing the demographic characteristics of patients with STBI, as well as parameters such as clinical laboratory test indicators.MethodsA retrospective analysis was performed on 139 STBI patients admitted to the Department of Emergency Medicine, General Hospital of Eastern Theater Command from January 2017 to December 2018. According to the 28-day death event, the participants were divided into the survival group (n=108) and the death group (n=31). Indicators such as Glasgow Coma Score (GCS), red blood cell distribution width (RDW), platelet distribution width (PDW) and clot-related indicators were collected. Univariate and multivariate logistic regression were used to analyze the risk factors related to death, and receiver operating characteristic (ROC) curve was adopted to determine their prognostic values.ResultsThere were significant differences in GCS, RDW and PDW between the two groups. RDW (OR=4.577, 95% CI: 1.704-12.291), PDW (OR=1.346, 95% CI: 1.093-1.657) and GCS (OR=0.469, 95% CI: 0.301-0.730) were risk factors for death of STBI patients. The area under the curve (AUC) of RDW, PDW and GCS scores were 0.735 (0.640-0.840), 0.675 (0.553-0.796) and 0.737 (0.638-0.837), respectively, and the AUC of the combination of the three was 0.840 (0.748-0.932), which was significantly better than that of single diagnosis.ConclusionRDW, PDW combined with GCS can effectively evaluate the prognosis of patients with STBI, which has important guiding value for clinicians′ diagnosis and treatment.
ABSTRACT
ABSTRACT Background: Preeclampsia is one of the major health problems causing maternal morbidity and mortality, complicating 3-8% of pregnancies. It has been suggested that the alterations in the coagulation and fibrinolysis play a role in the pathogenesis of preeclampsia. The markers of platelet activation include platelet count, platelet distribution width, mean platelet volume and plateletcrit. Study design: It was a case-controlled study which included a total of 60 patients (30 cases and 30 controls). Blood samples were collected and the platelet indices - platelet count, plateletcrit, mean platelet volume and platelet distribution width - were evaluated using the Sysmex XN1000 and compared between the two groups. Results: The MPV and PDW also showed a significant difference (p > 0.05) between the two groups, with a significant positive correlation with increasing blood pressure (MPV - r = +0.6126, p < 0.05 and PDW - r = +0.6441, p < 0.05). The PC and PCT had lower values in the preeclampsia patients, however the difference between the two groups was not statistically significant. Conclusion: The MPV and PDW showed a significant difference between the two groups and increasing values with increasing BP. However, the PC and PCT in our study did not show a significant correlation with preeclampsia. Thus, the platelet indices, mainly the MPV and PDW, which are economical and easily available, can be reliable in the prediction and early diagnosis of preeclampsia, as well as a marker for the severity of preeclampsia.
Subject(s)
Humans , Female , Adult , Platelet Count , Pre-Eclampsia , Mean Platelet VolumeABSTRACT
Objective@#To investigate the value of routine indexes of blood, biochemistry and coagulation in assessing microcirculation in children with sepsis, and explore the related mechanism.@*Methods@#The clinical data of 187 children with sepsis from July 2013 to July 2018 in Wuxi Children′s Hospital of Jiangsu Province were retrospectively analyzed. The lactic acid, D- dimmer (DD), platelet distribution width (PDW), red blood cell volume distribution width (RDW), albumin, capillary refill time (CRT), simplify pediatric clinical illness score (PCIS) and prognosis were observed. The children were divided into 3 groups according to the simplify PCIS: non-severe group (simplify PCIS>80 scores, 96 cases), severe group (simplify PCIS 71 to 80 scores, 64 cases), and extremely severe group (simplify PCIS ≤ 70 scores, 27 cases); the children were divided into 2 groups according to the prognosis: survival group (161 cases) and death group (26 cases); the children were divided into 3 groups according to the CRT: capillary refilling better group (CRT<1.0 s, 99 cases), capillary refilling infaust group (CRT 1.0 to 2.9 s, 60 cases), capillary refilling bad group (CRT ≥ 3.0 s, 28 cases).@*Results@#The lactic acid, DD, PDW, RDW and fatality rate in non-severe group, severe group and extremely severe group were gradually increased: (2.281 ± 1.103), (4.839 ± 2.154), (7.019±3.014) mmol/L; (2.103 ± 0.133), (3.632 ± 0.218), (5.179 ± 0.113) mg/L; 0.122 ± 0.010, 0.149 ± 0.011, 0.177 ± 0.016; 0.137 ± 0.012, 0.151 ± 0.018, 0.169 ± 0.021; 2.08% (2/96), 14.06% (9/64), 55.56% (15/27), while the albumin was gradually decreased: (34.21 ± 13.72), (30.38 ± 18.63), (22.37 ± 16.31) g/L, and there were statistical differences (P<0.01). The lactic acid, DD, PDW and RDW in survival group were significantly lower than those in death group: (3.127 ± 1.312) mmol/L vs. (6.837 ± 2.174) mmol/L, (2.473 ± 1.713) mg/L vs. (4.213 ± 1.101) mg/L, 0.124 ± 0.012 vs. 0.170 ± 0.023 and 0.148 ± 0.022 vs. 0.171 ± 0.017, while the albumin was significantly higher than that in death group: (33.59 ± 16.90) g/L vs. (19.92 ± 18.70) g/L, and there were statistical differences (P<0.01 or <0.05). The lactic acid, DD, PDW and RDW in capillary refilling better group, capillary refilling infaust group and capillary refilling bad group were gradually increased: (2.362 ± 2.131), (5.312 ± 1.114), (8.121 ± 2.213) mmol/L; (2.072 ± 0.213), (3.923 ± 0.178), (5.317 ± 0.517) mg/L; 0.119 ± 0.021, 0.153 ± 0.012, 0.171 ± 0.011; 0.127 ± 0.021, 0.148 ± 0.015, 0.168 ± 0.027; while the albumin was gradually decreased: (35.37 ± 14.11), (31.21 ± 15.13), (22.87 ± 15.22) g/L, and there were statistical differences (P<0.01).@*Conclusions@#The lactic acid, DD, PDW, RDW, ALB and CRT have some value in assessing microcirculation in children with sepsis, and the change of component and construction in microcirculation is the cause of developing of these indexes.
ABSTRACT
Objective To investigate the application value of susceptibility weighted imaging (SWI) combined with platelet distribution width (PDW) in intravenous thrombolysis for treatment of patients with acute cerebral infarction (ACI). Methods One hundred and ten patients with ACI treated by intravenous thrombolysis admitted to the Department of Radiology of the Second Affiliated Hospital of Medical College of Zhejiang University from February 2017 to June 2018 were enrolled as the subjects. Before treatment, all patients were detected by routine magnetic resonance imaging (MRI), SWI scanning and PDW detection. The patients were divided into hemorrhage group (77 cases) and non-hemorrhage group (33 cases) according to the presence or absence of hemorrhage shown in SWI, and according to the amount of bleeding, the hemorrhage group patients were subdivided into light (24 cases), medium (32 cases) and severe (21 cases) three groups. After intravenous thrombolysis, the patients were scanned by SWI to show whether bleeding being present or not, the cerebral microbleeding (CMBs) after 24 hours treatment in two groups, and after treatment of 14 days, modified Rankin score (MRS), PDW and hemorrhagic transformation (HT) situation in the two groups were evaluated and compared, the differences in hemorrhagic infarction 1 (HI1), hemorrhagic infarction 2 (HI2), parenchymal hemorrhage 1 (PH1) and parenchymal hemorrhage 2 (PH2) in different bleeding volume groups were compared. Results Before treatment, 129 lesions detected by SWI were significantly greater than 14 lesions detected by T1 weighted imaging, 22 lesions detected by T2 weighted imaging and 86 lesions detected by diffusion weighted imaging. After treatment for 24 hours, the number of CMBs (number: 10 vs. 0), after treatment for 14 days, the incidence of HT [36.36% (28/77) vs. 12.12% (4/33)], MRS (1.78±0.39 vs. 1.51±0.42) and PDW [(12.34±5.29)% vs. (6.79±3.27)%] in the hemorrhagic group were higher than those in non-hemorrhagic group (all P < 0.05). After treatment of 14 days, the incidences of HT [71.43% (15/21) vs. 20.83% (5/24), 25.00% (8/32)], PDW [(14.52±4.11)% vs. (10.78±3.67)%, (11.34±3.89)%] in severe group were higher than those in light group and moderate groups (all P < 0.05), and the rate of good prognosis was significantly lower than those in mild and moderate groups [42.86% (9/21) vs. 70.83% (17/24), 71.88% (23/32), P < 0.05]. The incidence of HT in severe group was also significantly higher than those in the non-hemorrhage group [71.43% (15/21) vs. 11.76% (4/34), P < 0.05]. Conclusion SWI combined with PDW can guide the intravenous thrombolysis very well for patients with ACI, and has relatively high clinical value.
ABSTRACT
Objective To investigate the value of routine indexes of blood, biochemistry and coagulation in assessing microcirculation in children with sepsis, and explore the related mechanism. Methods The clinical data of 187 children with sepsis from July 2013 to July 2018 in Wuxi Children′s Hospital of Jiangsu Province were retrospectively analyzed. The lactic acid, D- dimmer (DD), platelet distribution width (PDW), red blood cell volume distribution width (RDW), albumin, capillary refill time (CRT), simplify pediatric clinical illness score (PCIS) and prognosis were observed. The children were divided into 3 groups according to the simplify PCIS: non-severe group (simplify PCIS＞80 scores, 96 cases), severe group (simplify PCIS 71 to 80 scores, 64 cases), and extremely severe group (simplify PCIS≤70 scores, 27 cases); the children were divided into 2 groups according to the prognosis: survival group (161 cases) and death group (26 cases); the children were divided into 3 groups according to the CRT: capillary refilling better group (CRT﹤1.0 s, 99 cases), capillary refilling infaust group (CRT 1.0 to 2.9 s, 60 cases), capillary refilling bad group (CRT ≥ 3.0 s, 28 cases). Results The lactic acid, DD, PDW, RDW and fatality rate in non-severe group, severe group and extremely severe group were gradually increased: (2.281 ± 1.103), (4.839 ± 2.154), (7.019 ± 3.014) mmol/L; (2.103 ± 0.133), (3.632 ± 0.218), (5.179 ± 0.113) mg/L; 0.122 ± 0.010, 0.149 ± 0.011, 0.177 ± 0.016; 0.137 ± 0.012, 0.151 ± 0.018, 0.169 ± 0.021; 2.08% (2/96), 14.06% (9/64), 55.56% (15/27), while the albumin was gradually decreased: (34.21 ± 13.72), (30.38 ± 18.63), (22.37 ± 16.31) g/L, and there were statistical differences (P﹤0.01). The lactic acid, DD, PDW and RDW in survival group were significantly lower than those in death group: (3.127 ± 1.312) mmol/L vs. (6.837 ± 2.174) mmol/L, (2.473 ± 1.713) mg/L vs. (4.213 ± 1.101) mg/L, 0.124 ± 0.012 vs. 0.170 ± 0.023 and 0.148 ± 0.022 vs. 0.171 ± 0.017, while the albumin was significantly higher than that in death group: (33.59 ± 16.90) g/L vs. (19.92 ± 18.70) g/L, and there were statistical differences (P﹤0.01 or﹤0.05). The lactic acid, DD, PDW and RDW in capillary refilling better group, capillary refilling infaust group and capillary refilling bad group were gradually increased: (2.362 ± 2.131), (5.312 ± 1.114), (8.121 ± 2.213) mmol/L; (2.072 ± 0.213), (3.923 ± 0.178), (5.317 ± 0.517) mg/L; 0.119 ± 0.021, 0.153 ± 0.012, 0.171 ± 0.011; 0.127 ± 0.021, 0.148 ± 0.015, 0.168 ± 0.027; while the albumin was gradually decreased: (35.37 ± 14.11), (31.21 ± 15.13), (22.87 ± 15.22) g/L, and there were statistical differences (P﹤0.01). Conclusions The lactic acid, DD, PDW, RDW, ALB and CRT have some value in assessing microcirculation in children with sepsis, and the change of component and construction in microcirculation is the cause of developing of these indexes.
ABSTRACT
Background: Hematocrits have always been helpful to doctors as they are important parameters used on a daily basis. With the latest technology one can measure different indices of platelets mainly Plateletcrit, PC, MPV, PDW. Aim and objectives: To study the role of platelet distribution width as a prognostic factor of outcome in hemorrhagic stroke. Materials and methods: This study included 35 patients of hemorrhagic stroke coming to MGM hospital, Kamothe. Results: The study contained of 13 females and 22 male patients. Group A consisted of 5 patients. As the patients expired within 24 hours, only a single value of PDW was available in these patients. The mean of the PDW of these patients was 16.92 with a SD of 1.22. Conclusion: PDW may act as a prognostic factor of mortality in hemorrhagic stroke.
ABSTRACT
Objective:Activating platelets are associated with tumor development and progression.Platelet distribution width(PDW) is an early index of activated platelets.The goal of this study was to investigate the association between prognosis and preoperative PDW in gastric cancer.Methods:A total of 126 gastric cancer patients were retrospectively analyzed from January 2010 to January 2012.The optimal cutoff value of PDW was determined by time-dependent receiver-operating curves.The patients were divided into low and high PDW groups.The prognostic analysis was carried out with univariate analysis and the Cox regression model,which evalu-ated the association of PDW,with progression-free survival(PFS)and overall survival(OS).Results:PDW was closely related with differ-entiation and platelet count.Moreover,lower PDW was associated with decreased PFS and OS in gastric cancer.Multivariate analysis showed that patients with higher PDW had a lower risk of disease progression(hazard ratio:0.562,95% confidence interval:0.184-0.926,P=0.012)and death(hazard ratio:0.468,95% confidence interval:0.263-0.834,P=0.010).Conclusions:Lower preoperative PDW is a poor prognostic factor in gastric cancer,which may also be a prognostic marker in resectable gastric cancer.
ABSTRACT
Objective To investigate the relationship between mean platelet volume (MPV) and diabetic macular edema (DME) in type 2 diabetic patients.Methods The study included 4 patient groups:40 healthy control as group 1,40 diabetic patients without diabetic retinopathy(DR) as group 2,40 DR patients without DME as group 3,and 40 DR patients with DME as group 4.Then the collection of general information,fundus photograph and OCT were conducted for the measurement and comparison of serum levels of platelet parameters including platelet count (PLT),MPV,platelet distribution width (PDW) and plateletcrit (PCT).Results Significant differences were found in MPV and PDW among the four groups (all P ＜ 0.05),but there was no significant difference in PLT and PCT levels (all P ＜ 0.05).Furthermore,MPV and PDW level was (11.07 ± 1.06)fL and (13.57 ±2.25)fL in group 3,as well as (11.27 ±0.85)fL and (13.89 ± 1.76)fL in group 4,respectively,which were both significantly higher than those in group 1 [(10.41 ±0.63)fL and (11.93 ± 1.22)fL] as well as in group 2 [(10.38 ± 0.51) fL and (12.33 ± 1.28) fL] (all P ＜ 0.05).Both MPV and PDW levels of group 4 were higher than those of group 3,but there was no significant difference (P =0.254,0.388).As for males,MPV level was increased gradually in group 2 [(10.29 ±0.58)fL],group 3 [(10.67 ± 1.08)fL] and group 4 [(11.42 ±0.90) fL] (all P＜0.05),but there was no significant difference between group 1 [(10.27 ± 0.55)fL] and group 2.For females,MPV level was (11.37 ± 0.69) fL in group 3 and (11.13 ± 0.79) fL in group 4,both which were significantly higher than that in group 1 [(10.55 ± 0.70) fL] and group 2 [(10.42 ± 0.49) fL],respectively (all P ＜ 0.05),but there was no significant difference between group 3 and group 4 (P ＞ 0.05).Conclusion High MPV level may be an important risk factor for the development of DME in DR patients.Platelet parameter surveillance can aid in the monitoring of this disease.
ABSTRACT
Objective To investigate the clinical value of platelet parameters in patients with acute myocardial infarction(AMI) in plateau.Methods A total of 72 patients diagnosed as acute myocardial infarction in our department from January 2016 to June 2017 were enrolled into this study.Clinical data and outcomes were analyzed.Platelet parameters were measured within 24 h after AMI occurrence.The relationship between platelet distribution width (PDW),mean platelet volume (MPV),and the severity of disease,infarct size as well as short-term prognosis were further investigated.Results Compared with control group,PDW and MPV were positively correlated with the severity of disease (PPDW=0.039,PMPV=0.038) and infarct size (rPDW=0.305,P=0.009;rMPV=0.263,P=0.025).The AUC of PDW was 0.827,optimal operating point (OOP) was 16.3％,the AUC of MPV was 0.813,OOP was 13.1 fl,the AUC of GRACE was 0.865,OOP was 145.Conclusions PDW and MPV could be regarded as laboratory index to evaluate the severity of disease,infarct size,pathological changes of coronary artery and short-term prognosis of acute myocardial infarction in plateau.
ABSTRACT
Objective To investigate the influences of platelet distribution width (PDW) on the prognosis of nasopharyngeal cancer patients.Methods A total of 186 patients with nasopharyngeal cancer from January 2009 to December 2013 in our hospital were selected.The patients were aged from 48 to 79 years old,with an average age (61.8 +8.2) years old.The age,gender,lung function,liver function,body mass index (BMI),smoking,drinking,histological type and staging of patients were recorded.The patients were followed up after discharge,and the mean follow up period was 28 months (12-36 months).The terminal event was nasopharyngeal cancer related death or the end of follow up.The best threshold of receiver operating characteristic (ROC) curve for the overall survival rate of PDW was tested,and the patients were divided into ≥ best threshold group and ＜ best threshold group.The prognostic factors were analyzed by single factor analysis and Cox multiple regression analysis.Results The best threshold of ROC curve for the overall survival rate of PDW was 16.4％.The patients were divided into PDW≥ 16.4％ group and PDW ＜ 16.4％ group.There were no statistically significant differences in age (t =0.712,P =0.478),gender (x2=0.044,P =0.834),BMI (t =0.593,P =0.554),smoking (x2 =0.063,P =0.802),drinking (x2 =0.555,P =0.456),forced expiratory volume in one second/forced vital capacity (FEV1/FVC,t =1.711,P =0.089),alanine transaminase (ALT,t =1.756,P =0.081),histological type (x2 =0.259,P =0.879) and staging (Z =2.443,P =0.486) between the two groups.Results of single factor analysis showed that there were statistically significant differences in age (x2 =4.611,P =0.032),gender (x2 =3.952,P =0.047),smoking (x2 =5.564,P =0.018),FEV1/FVC (x2 =4.321,P=0.038),staging (x2 =6.021,P =0.014) and PDW (x2 =4.511,P =0.034) between the two groups.Cox risk model of multifactor analysis showed that the elderly (≥60 years,x2 =5.429,P =0.020),male patients (x2 =4.648,P =0.031),smoking (x2 =18.453,P ＜0.001),Ⅲ-Ⅳ staging (x2 =9.612,P =0.002) and PDW ≥ 16.4％ (x2 =6.008,P =0.014) were independent prognostic factors in patients with nasopharyngeal cancer.Conclusion The degree of PDW in patients with nasopharyngeal cancer affects the prognosis of patients,and the patients with PDW ≥ 16.4％ have the better prognosis.
ABSTRACT
OBJECTIVES: We conducted this study to evaluate the diagnostic value of hematologic markers for moderate to severe obstructive sleep apnea syndrome (OSAS). METHODS: We performed the study using medical records from our sleep disorders center. We collected information regarding obstructive apnea-hypopnea index (oAHI), age, sex, body mass index, and complete blood counts with differential counts [white blood cell (WBC) count, neutrophil count, lymphocyte count, red blood cell distribution width (RDW), mean platelet volume, platelet count, platelet distribution width (PDW), neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio]. We excluded patients who were younger than 2 years, older than 14 years, obese/underweight, and those who had a hematologic or severe medical illness. RESULTS: We assessed records from 57 patients (7.98±3.25 years old, 35 men). We classified the subjects into three groups based on their oAHI scores, as follows: normal (oAHI < 1), mild OSAS (1≤oAHI < 5), and moderate/severe OSAS (oAHI≥5). Using a multivariate multinomial logistic regression model (pseudo R²=0.33), we found significant differences among the groups in RDW [moderate/severe OSAS vs. mild OSAS, adjusted odds ratio (OR): 8.77, p-value: 0.03], PDW (mild OSAS vs. normal, adjusted OR: 1.05, p-value: 0.04), and WBC (moderate/severe OSAS vs. normal, adjusted OR: 1.42, p-value: 0.03). CONCLUSIONS: RDW, PDW, and WBC had diagnostic value for moderate/severe OSAS in our study. Further prospective and validation studies are required to develop a screening tool for moderate/severe OSAS in children and adolescents.