【摘要】 目的 探讨中型和重型颅脑损伤后患者血小板（platelet，Plt）参数的变化特点及临床意义。 方法 选取2009年3月-2010年3月脑外伤后24 h内入院的颅脑损伤患者75例作为观察组，于伤后1、3、7、14 d采血测定Plt数量、血小板平均体积（mean platelet volume，MPV）、血小板体积分布宽度（platelet distribution width，PDW），并同时进行格拉斯哥昏迷评分（Glasgow coma scale，GCS）。同时选取60例健康体检者，测定Plt、MPV和PDW作为对照组。 结果 观察组伤后1、3、7 d Plt计数分别为（106.21±36.31）、（102.76±35.23）、（108.37±31.32）×109/L，较对照组[（210.41±68.56）×109/L]明显降低（P lt;0.05）；观察组伤后1、3、7 d MPV分别为（12.34±1.34）、（11.21±1.52）、（10.78±1.36） fL，PDW分别为（15.78±1.26）、（17.67±1.16）、（16.72±1.21） fL，均较对照组[MPV：（8.24±1.76） fL，PDW：（12.86±1.42） fL]明显升高（P lt;0.05）；伤后14 d Plt、MPV和PDW均较对照组差异无统计学意义（P gt;0.05）。GCS≤8分组伤后1 d Plt计数为（96.85±36.52）×109/L，明显低于GCS gt;8分组[（123.85±35.78）×109/L]，而GCS≤8分组MPV为（12.14±1.32） fL，PDW为（18.63±1.21） fL，均明显高于GCS gt;8分组[MPV：（9.78±1.34） fL，PDW：（16.72±1.34） fL]，差异均有统计学意义（P lt;0.05）。伤后第1天Plt与随访6个月GOS评分呈正相关（r=0.625，P lt;0.05）。 结论 中型和重型颅脑损伤后Plt计数明显降低，MPV和PDW值明显升高，且与伤情及预后有关。Plt及其参数的检测有助于对伤情、预后的判断。
【Abstract】 Objective To investigate the platelet parameters changes and its clinical significance in medium and severe head injury patients. Methods From March 2009 to March 2010, 75 brain injury patients hospitalized within 24 h after injury were included in this study. The platelet number (Plt), mean platelet volume (MPV), platelet volume distribution width (PDW) and Glasgow coma scale were measured on the first, third, seventh and fourteenth day after injury respectively. We also measured the Plt, MPV and PDW of 60 healthy volunteers to make comparisons. Results The Plt counts were (106.21±36.31), (102.76±35.23), and (108.37±31.32)×109/L in the head injury patients on the first, third, and 7th day respectively, which were significantly lower than those in the control group [(210.41±68.56)×109/L] (P lt;0.05); the MPV and PDW values measured on the first day [MPV: (12.34±1.34) fL, PDW: (15.78±1.26) fL] and the third day [MPV: (11.21±1.52) fL, PDW: (17.67±1.16)fL] were both significantly lower than those of the control group (P lt;0.05); There was no evidence of a difference in Plt, MPV and PDW between the two groups fourteen day after injury (P＞0.05); The Plt count was (96.85±36.52)×109/L in GCS≤8 group on the first day, which was significantly lower than that of GCS gt;8 group [(123.85±35.78) fL, P lt;0.05]; However, the MPV and PDW values in GCS≤8 group [(MPV: (12.14±1.32) fL, PDW: (18.63±1.21) fL] were both significantly higher than those of GCS gt;8 group [MPV: (9.78±1.34) fL, PDW: (16.72±1.34) fL, P lt;0.05]; The Plt count was correlated with GOS score positively (r=0.625,P lt;0.05). Conclusions Medium and severe head injury patients are significantly associated with a lower Plt count and increased MPV and PDW values. The Plt parameters changes are correlated with the prognosis of patients. Therefore, the measurement of Plt parameters may contribute to the valuation of severity and prognosis, and provide new ideas for treatment of head injury patients.
Citation： DAN Bing,ZENG Lingchun,PENG Zongqing,ZHENG Feng,YI Yong,ZENG Yijun,YU Shui,WANG Qiangping,DU Deming. Changes of Platelet Parameters in Patients with Head Injury and Its Clinical Significance. West China Medical Journal, 2011, 26(9): 1342-1344. doi: Copy