Graves病患者治疗前后血小板参数变化的研究

目的研究Graves病(Graves disease,GD)患者治疗前后血小板参数的变化及其意义。方法选择2009年7月至2009年12月间首都医科大学附属北京朝阳医院门诊GD患者共275例,其中治疗后缓解199例(缓解组),无缓解76例(无缓解组)。检测2组治疗前后血小板计数(platelet count,PLT)、血小板平均体积(mean platelet volume,MPV)、血小板分布宽度(plateletdistribution width,PDW)、大血小板比率(platelet-large cell ratio,P-LCR)以及血小板平均体积和大血小板比率治疗前后的差值(△MPV和△P-LCR)。结果治疗前缓解组和无缓解组相比,MPV和P-LCR差异有统计学意义(P<0.05)。治疗后缓解组和无缓解组MPV、PDW及P-LCR相比差异有统计学意义(P<0.01)。治疗前后2组的PDW、△MPV和△P-LCR比较,差异均有统计学意义(P<0.01)。治疗前P-LCR大于24.85%和治疗后小于30.55%均提示GD缓解的可能性较大。结论治疗后缓解组的MPV、PDW和P-LCR与治疗前相比均下降。2组治疗前后PDW、△MPV和△P-LCR比较,差异有统计学意义。本研究提示血小板参数特别是P-LCR的变化可作为GD治疗效果的参考指标。

Changes in platelet volume indices in patients with Graves’ disease before and after treatment

Objective To study the changes in platelet volume indices in patients with Graves’ disease(GD) before and after therapy. Methods From July 2009 to Dec. 2009, 275 patients with GD were enrolled in this study, 199 patients were euthyroid(Euthyroid group), 99 patients were still hyperthyroid(Hyperthyroid group). Platelet count(PLT), mean platelet volume(MPV), platelet distribution width(PDW), platelet-large cell ratio(P-LCR) and changes of mean platelet volume(△MPV) and platelet-large cell ratio(△P-LCR) were measured. Results Before therapy, compared to patients with euthyroid state, MPV and P-LCR were significantly lower in patients with hyperthyroid state. After therapy, MPV, PDW and P-LCR were significantly higher in the hyperthyroid group. Before and after therapy in two groups, PDW, △MPV and △P-LCR were significantly different(P<0.01). P-LCR was higher than 24.85% before therapy and lower than 30.55% after therapy, which suggest that GD patients may have been in euthyroid state after therapy. Conclusion GD patients achieved euthyroid state after treatment, there were falls in MPV, PDW and P-LCR than before. There were significant differences in PDW, △MPV and △P-LCR in the two groups before and after therapy. P-LCR suggested that the therapy may be effective and it maybe features of GD that have not previously been described.