Use of mean platelet volume improves detection of platelet disorders

Classification of platelet disorders has been based on the platelet count. Addition of a second variable, mean platelet volume (MPV), to the routine blood count allows classification of patients into 9 categories: high, low, or normal MPV, and high, low or normal platelet count. We studied 1,244 adult inpatients. 1,134 had both platelet values normal. 11 patients had high MPV and low platelet count: all had hyperdestructive causes. 15 patients had high MPV and normal platelet count: 12 had heterozygous thalassemia, and three had iron deficiency. Seven patients had high MPV and high platelet count: causes included myeloproliferative disorders, inflammation, iron deficiency, and splenectomy, 25 patients had high platelet counts and normal MPV: the causes were inflammation, infection, sickle cell anemia, iron deficiency, or chronic myelogenous leukemia. 52 patients had an MPV that was inappropriately low for the platelet count (high, normal, or low). All had sepsis, splenomegaly, aplastic anemia, chronic renal failure, or a disease being treated with myelosuppressive drugs. High MPV thus appears correlated with myeloproliferative disease or thalassemia; and low MPV, with cytotoxic drugs or marrow hypoplasia. Addition of MPV to the platelet count allows subtler disorders to be detected (when the platelet count is normal), and allows distinction of the cause of thrombocytopenia.     

Thrombocytopenia in liver cirrhosis complicated by variceal haemorrhage: lack of increase in platelet count after spleno renal distal shunt

10 patients with liver cirrhosis (LC) and previous variceal bleeding have been studied. Platelet count was markedly depressed. Giant platelet percentage (MTI) was significantly increased, reflecting bone marrow compensatory hyperactivity. Platelet associated IgG (PAIgG) was elevated. Such elevation, however, was inconstant and did not correlate with platelet count. Beta-thromboglobulin was markedly increased when referred to circulating platelet number, but its level did not accurately reflect platelet activation, because of decreased liver cell function. Platelet Factor 4 was always zero, thus confirming that high values of this protein represent only a laboratory artifact, due to platelet activation in vitro. 5 patients underwent spleno renal distal shunt, which transiently improved hypersplenism only in one case. Despite this, MTI became perfectly normal in all patients, suggesting a decrease in the thrombopoietic stimulus. PAIgG dramatically fell in the two patients with the highest pre-operative values. Since thrombocytopenia persisted, the non-specific nature of PAIgG in LC seems to be further supported.     

Association of Adiposity Indices with Platelet Distribution Width and Mean Platelet Volume in Chinese Adults

Hypoxia is a prominent characteristic of inflammatory tissue lesions. It can affect platelet function. While mean platelet volume (MPV) and platelet distribution width (PDW) are sample platelet indices, they may reflect subcinical platelet activation. To investigated associations between adiposity indices and platelet indices, 17327 eligible individuals (7677 males and 9650 females) from the Dongfeng-Tongji Cohort Study (DFTJ-Cohort Study, n=27009) were included in this study, except for 9682 individuals with missing data on demographical, lifestyle, physical indicators and diseases relative to PDW and MPV. Associations between adiposity indices including waist circumstance (WC), waist-to-height ratio (WHtR), body mass index (BMI), and MPV or PDW in the participants were analyzed using multiple logistic regressions. There were significantly negative associations between abnormal PDW and WC or WHtR for both sexes (p _trend<0.001 for all), as well as abnormal MPV and WC or WHtR among female participants (p _trend<0.05 for all). In the highest BMI groups, only females with low MPV or PDW were at greater risk for having low MPV (OR=1.33, 95% CI=1.10, 1.62 p _trend<0.001) or PDW (OR=1.34, 95% CI=1.14, 1.58, p _trend<0.001) than those who had low MPV or PDW in the corresponding lowest BMI group. The change of PDW seems more sensitive than MPV to oxidative stress and hypoxia. Associations between reduced PDW and MPV values and WC, WHtR and BMI values in Chinese female adults may help us to further investigate early changes in human body.     

急性心理应激下血小板活化参数的变化及其机制探讨

目的:探讨急性心理应激下健康人群血小板活化参数的变化及其与性别、年龄的相关性,并分析其可能的机制。方法:检测54名健康被试者急性心理应激前后的血小板四项变化,包括血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)和大血小板比率(P-LCR)。随后,将被试者分成男、女性组或中、老年组,对其血小板四项结果进行组内及组间比较。结果:急性心理应激可导致健康人群中MPV、PDW和P-LCR的显著增加(P0.05),但年龄分组或性别分组组间均未见显著差异(P0.05)。结论:实验性急性心理应激可导致健康人群血小板活化指标MPV、PDW和P-LCR的显著增加,但与年龄和性别无关。     

The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes

Introduction

Thrombotic and inflammatory mechanisms are involved in the pathophysiology of acute coronary syndrome (ACS). The aim of the study was the evaluation of inflammation (white blood cells count/WBC, C-reactive protein/CRP, interleukin-6/IL-6) and platelet (platelet count/PLT, mean platelet volume/MPV, large platelet/LPLT, beta-thromboglobulin/β-TG) biomarkers in the groups of ACS patients depending on the severity of signs and symptoms and compared to controls without coronary artery disease.

血常规在头颈部鳞状细胞癌早期诊断中的作用

目的:探究血常规指标在头颈部鳞状细胞癌早期诊断中的作用,从血液学的角度为头颈部鳞状细胞癌的早期诊断提供参考依据。方法:对181例头颈部良恶性肿瘤患者的血常规结果进行回顾性分析,比较头颈部鳞状细胞癌患者组(实验组)和头颈部良性肿瘤组(对照组)患者的血小板计数(PLT)、血小板比积(PCT)、血小板平均容积(MPV)、血小板分布宽度(PDW)、大血小板比率(P-LCR)、中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、单核细胞计数(MONO)、嗜酸性粒细胞计数(EOS)、嗜碱性粒细胞计数(BASO)、血小板计数/淋巴细胞计数比值(PLR)以及中性粒细胞计数/淋巴细胞计数比值(NLR)共12个指标。结果:实验组和对照组的PLT、PCT、MPV、PDW、P-LCR以及BASO计数值比较均没有统计学差异(p0.05)。对照组NEU、MONO、EOS、PLR和NLR均低于实验组,而LYM计数值高于实验组,其差异均具有统计学意义(p0.05),ROC曲线显示NLR对于早期诊断的意义要优于PLR。结论:血小板相关指标在头颈部鳞状细胞癌早期诊断中无明显意义,白细胞亚型计数具有重要的提示作用,而NLR的诊断意义要高于PLR,或许可以联合其他鳞癌标志物进行早期诊断。     

不同分级及转归脓毒症患者血清PCT、D-D、CRP及血小板相关参数检测的临床意义

目的:探讨不同分级及转归脓毒症患者的血清降钙素原(PCT)、D-二聚体(D-D)、C反应蛋白(CRP)及血小板相关参数检测的临床意义。方法:回顾性分析2015年3月至2018年8月期间中国人民解放军西部战区总医院收治的92例脓毒症患者的临床资料,分析不同分级及转归脓毒症患者的血清中PCT、D-D和CRP水平、急性病生理与慢性健康评价系统Ⅱ(APACHEⅡ)评分及血小板相关参数[血小板计数(PLT)、血小板平均容积(MPV)、血小板分布宽度(PDW)、大型血小板比率(P-LCR)],并分析脓毒症患者PCT、D-D、CRP水平以及血小板相关参数与APACHEⅡ评分的相关性。结果:全身炎症反应综合征组、轻度脓毒症组、严重脓毒症组、脓毒性休克组血清PCT、D-D和CRP水平、MPV、PDW、P-LCR、APACHEⅡ评分逐渐升高(P0.05),PLT逐渐降低(P0.05)。存活组患者血清PCT、D-D、CRP水平、MPV、PDW、P-LCR、APACHEⅡ评分均低于死亡组(P0.05),PLT高于死亡组(P0.05)。Pearson相关分析显示,脓毒症患者血清PCT、D-D、CRP、MPV、PDW、P-LCR与APACHE II评分呈正相关(P0.05),PLT与APACHE II评分呈负相关(P0.05)。结论:脓毒症患者血清PCT、D-D、CRP及血小板相关指标可能参与了脓毒症的发展,通过检测其血清PCT、D-D、CRP水平及血小板相关参数可评估脓毒症患者的病情和预后。     

A meta-analysis and genome-wide association study of platelet count and mean platelet volume in african americans

Several genetic variants associated with platelet count and mean platelet volume (MPV) were recently reported in people of European ancestry. In this meta-analysis of 7 genome-wide association studies (GWAS) enrolling African Americans, our aim was to identify novel genetic variants associated with platelet count and MPV. For all cohorts, GWAS analysis was performed using additive models after adjusting for age, sex, and population stratification. For both platelet phenotypes, meta-analyses were conducted using inverse-variance weighted fixed-effect models. Platelet aggregation assays in whole blood were performed in the participants of the GeneSTAR cohort. Genetic variants in ten independent regions were associated with platelet count (N?=?16,388) with p<5×10(-8) of which 5 have not been associated with platelet count in previous GWAS. The novel genetic variants associated with platelet count were in the following regions (the most significant SNP, closest gene, and p-value): 6p22 (rs12526480, LRRC16A, p?=?9.1×10(-9)), 7q11 (rs13236689, CD36, p?=?2.8×10(-9)), 10q21 (rs7896518, JMJD1C, p?=?2.3×10(-12)), 11q13 (rs477895, BAD, p?=?4.9×10(-8)), and 20q13 (rs151361, SLMO2, p?=?9.4×10(-9)). Three of these loci (10q21, 11q13, and 20q13) were replicated in European Americans (N?=?14,909) and one (11q13) in Hispanic Americans (N?=?3,462). For MPV (N?=?4,531), genetic variants in 3 regions were significant at p<5×10(-8), two of which were also associated with platelet count. Previously reported regions that were also significant in this study were 6p21, 6q23, 7q22, 12q24, and 19p13 for platelet count and 7q22, 17q11, and 19p13 for MPV. The most significant SNP in 1 region was also associated with ADP-induced maximal platelet aggregation in whole blood (12q24). Thus through a meta-analysis of GWAS enrolling African Americans, we have identified 5 novel regions associated with platelet count of which 3 were replicated in other ethnic groups. In addition, we also found one region associated with platelet aggregation that may play a potential role in atherothrombosis.     

PLT,MPV,PDW对单采血小板产品聚集的影响

目的：探讨血小板含量（PLT）,血小板平均分布宽度（PDW）,血小板平均体积（MPV）对单采血小板聚集的影响,方法：随机抽取68例血小板捐献者,均成功捐献单采血小板,分为聚集组和对照组。献血前抽取静脉血,采用麦道尼克CA620血细胞分析仪进行血细胞分析,检测PLT,MPV,PDW。结果：聚集组（%）PDW 17.5±1.8,高于对照组（%）PDW12.1±0.9（P〈0.05）。聚集组（fl）MPV 11.0±0.9高于对照组（fl）MPV 7.8±0.8（P〈0.05）,差异有统计学意义,聚集组PLT（187±13.3）×109,对照组PLT（195±11.0）×109,二者无明显统计学差异（P〉0.05）。MPV,PDW分别与PLT进行相关性分析,PLT与MPV无显著相关（r=0.132,P〉0.05）;PLT与PDW无显著相关（r=0.147,P〉0.05）。结论：单采血小板产品出现聚集,其捐献者PDW,MPV高于单采产品正常捐献者,与献血者PLT计数无明显关系。     

阻塞性睡眠呼吸暂停低通气综合征患者MPV、PDW、RDW的相关性及其临床意义

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的平均血小板体积(MPV)、血小板分布宽度(PDW)、红细胞分布宽度(RDW)的相关性及其临床意义。方法:选取2016年4月-2018年4月我院收治的OSAHS患者105例,对所有入组患者的诊疗资料、检查数据进行综合性的整理与分析。将所有入组的OSAHS患者按呼吸暂停通气不足指数(AHI)分成轻中度组45例(5次/h≤AHI30次/h)和重度组60例(AHI≥30次/h)。观察比较两组的AHI指数、脉搏氧饱和度低于90%(TSpO_290%)时间及最低血氧饱和度(LSaO_2),比较两组的MPV、PDW及RDW表达情况并探讨AHI与MPV、PDW及RDW之间的相关性。结果:重度组AHI、TSpO_290%时间高于轻中度组,差异有统计学意义(P0.05);重度组LSaO_2低于轻中度组,差异有统计学意义(P0.05)。重度组MPV、PDW显著高于轻中度组,差异有统计学意义(P0.05);重度组RDW表达水平略高于轻中度组,但差异无统计学意义(P0.05)。相关性分析结果显示,AHI与MPV、PDW之间存在正相关性(r=0.601,0.587;P=0.021,0.030),AHI与RDW之间不存在相关性(r=0.024,P=0.071)。结论:OSAHS患者的病情发展情况与MPV、PDW之间存在独立的正相关性,但是与RDW之间不存在相关性。     

原发性高血压患者血浆ET-1含量与血小板参数相关性研究

目的:探讨血浆内皮素-1 (Endothelin-1,ET-1)含量变化和血小板功能异常在原发性高血压疾病进程中相关性及意义.方法:选择98例原发性高血压患者作为实验组和30例健康受试者作为正常对照组.实验组又根据高血压分级标准分为轻度高血压组(L组),中度高血压组(M组)和重度高血压组(S组),分别检测各组患者血浆ET-1含量和血小板各项参数值.结果:实验组血浆ET-1含量、平均血小板体积(mean platelet volume,MPV)、血小板分布宽度(platelet distribution width,PDW)明显高于对照组(P＜0.05),血小板计数(platelet count,PLT)和血小板压积(platelet hematocrit,PCT)明显低于对照组(P＜0.05);L组、M组和S组ET-1含量、MPV和PDW值呈进行性升高(P＜0.05),PLT和PCT值呈进行性降低(P＜0.05).结论:血浆ET-1含量和血小板各项参数变化与疾病的进展和危重程度存在相关性,对原发性高血压的诊断治疗及预后评估有重要意义.     

肾移植术后排斥反应患者肠道菌群、血小板参数的变化及其危险因素分析

目的:探讨肾移植术后排斥反应(AR)患者肠道菌群、血小板参数的变化及术后AR的危险因素。方法:选择接受肾移植的患者150例,术后发生AR 26例作为研究组,未发生AR 124例作为对照组,比较两组术前、术后肠道菌群变化及血小板参数变化,分析肾移植术后AR的危险因素。结果:术后研究组肠道乳酸杆菌、双歧杆菌的数量、双歧杆菌/肠杆菌较对照组减少,肠杆菌、肠球菌的数量较对照组增多(P0.05)。研究组术后5 d、7 d血小板比容(PCT)低于对照组,平均血小板容积(MPV)、血小板分布宽度(PDW)、血小板比率(P-LCR)高于对照组(P0.05)。多因素Logistic回归分析显示:术后乳酸杆菌数量减少、双歧杆菌数量减少、双歧杆菌/肠杆菌减少,肠杆菌数量增多、肠球菌数量增多,PCT降低、PDW升高、P-LCR升高为肾移植术后AR的危险因素(P0.05)。结论:肾移植术后AR患者肠道菌群失调,术后PCT降低,MPV、P-LCR升高。患者术后肠道菌群失调、PCT降低、PDW升高、P-LCR升高为AR的危险因素。     

猪2、7和8号染色体上影响血常规指标的数量性状基因座(QTL)检测

以3个品种（长白猪、大白猪、松辽黑猪）16个公猪家系共计368头仔猪组成资源群体,在猪2、7和8号染色体上共选取35个微卫星标记,采用基于线性混合模型的方差组分分析方法,对影响与猪白细胞、红细胞和血小板相关的共计18项血常规指标的数量性状基因座（quantitative trait loci,QTL）进行了检测．通过似然比检验,并以自由度为2的卡方分布作为检验统计量的分布,共发现22个在P〈5％水平下显著的QTL,其中在2号染色体上有9个,分别影响白细胞总数、中性粒细胞数、平均红细胞体积、血红蛋白含量、平均红细胞血红蛋白浓度、血小板总数、平均血小板体积、血小板分布宽度和血小板压积,在7号染色体有7个,分别影响白细胞总数、中性粒细胞数、平均红细胞血红蛋白浓度、血红蛋白含量、血小板总数、平均红细胞体积和红细胞分布宽度变异,在8号染色体上有6个,分别影响中性粒细胞百分比、淋巴细胞百分比、平均红细胞血红蛋白浓度、血小板总数、血小板压积和平均红细胞体积．为尽可能地避免由于多重检验所造成的假阳性率的升高,我们采用了控制假检出率（false discovery rate,FDR）的方法来对这22个QTL进行进一步检验,发现有14个达到FDR〈5％显著水平,其中又有9个达到FDR〈1％显著水平．     

Differences in Platelet Indices between Healthy Han Population and Tibetans in China

Introduction

The present data on the evaluation of platelet (PLT) parameters in Chinese Han population and Tibetans are still limited. The objective of this study was to determine the differences in common PLT indices between Han population and Tibetans in China, through a large-scale investigation of healthy people.

Methods

2131 Han people from Chengdu Plain, 1099 Tibetans from Qinghai-Tibet Plateau and 956 Plateau Han migrants were included in this study. All the subjects were healthy people through the health screening. PLT indices were measured with Sysmex XE-2100 and XT-1800i blood cell automatic analyzer.

Results

Compared with Han people in Chendu Plain, Tibetans had higher PLT count (P<0.01) but lower mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) (P<0.01); while Plateau Han migrants had lower PLT count, MPV and P-LCR (P<0.05). When compared with Tibetans, Plateau Han migrants had lower levels of mean PLT count but higher PDW and P-LCR (P<0.05).

Conclusions

There are ethnic differences in PLT indices between Chinese Han population and Tibetans. Based on this finding, it would be reasonable to conduct formal prospective studies to determine the clinical significance of these differences and to explore the effects of genetic background on these indices.     

The Impact of Various Platelet Indices as Prognostic Markers of Septic Shock

IntroductionPlatelet indices, including mean platelet volume (MPV), are readily available blood tests, although their prognostic value in patients with septic shock has not been fully explored. Current evidence has found contradictory results. This study aims to explore the behavior of platelet indices in septic shock and their clinical prognostic value.MethodsCharts of septic shock patients from January to December 2012 in a tertiary medical center in Northern China were reviewed retrospectively. Platelet indices were recorded during the first five consecutive days after admission, as well as the penultimate and the last day of hospital stay. The data were compared between surviving and non-surviving patients.ResultsA total of 124 septic shock patients were enrolled. Thirty-six of the patients survived and 88 of them expired. MPV in the non-survivor group was higher than that of the survivor group, especially on the last day. PDW and PLCR showed increased trends, while PCT and PLT decreased in the non-survivor group. Among the PLT indices, MPV had the highest area under the receiver operating characteristic curve (0.81) with a precision rate of 75.6% at a cut-off of 10.5.Compared with other more usual septic shock prognostic markers, MPV is second only to lactate for the highest area under the curve.ConclusionA statistically significant difference was seen between survivors and non-survivors for platelet indices which make them easily available and useful prognostic markers for patients in septic shock.     

Mean platelet volume: Interrelation with platelet aggregation activity and glycoprotein IIb-IIIa and Ib expression levels

Increased mean platelet volume (MPV) is an independent risk factor of thrombotic events in patients with cardiovascular diseases. Interactions of MPV with platelet aggregation activity and contents of glycoprotein (GP) IIb-IIIa (αIIb/β3 integrin, fibrinogen receptor) and GP Ib (von Willebrand factor receptor) have been investigated in this study. The study was performed in a group of healthy volunteers (n = 38) and a group of patients with acute coronary syndrome (ACS, n = 116). Patient’s blood was collected at days 1, 3–5 and 8–12 after ACS development. All patients received acetylsalicylic acid (ASA, inhibitor of thromboxane A2 synthesis) as the antiaggregant therapy and most of them also received clopidogrel (ADP receptor antagonist), except 44 patients who had not taken clopidogrel at day 1 before first blood collection. Aggregation of volunteers’ platelets was stimulated by 1.25, 2.5, 5 and 20 μM ADP, while aggregation of patients’ platelets was stimulated by 5 and 20 μM ADP. GP IIb-IIIa and GP Ib content on the platelet surface was measured using ¹²⁵I-labelled monoclonal antibodies. GP IIb-IIIa and GP Ib genetic polymorphisms were determined in ACS patients. In healthy donors significant correlations between MPV and aggregation levels have been recognized at 1.25 μM and 2.5 μM ADP (correlation coefficient (r) values of 0.396 and 0.373, p < 0.05), while at 5 μM and 20 μM ADP these interactions did not reach the level of statistical significance (r values of 0.279 and 0.205, p > 0.05). Correlations between MPV and aggregation levels were observed at day 1 of ACS in a subgroup of patients receiving ASA but before the beginning of clopidogrel treatment (r values of 0.526, p < 0.001 and 0.368, p < 0.05 for 5 and 20 μM ADP, respectively). Correlations between these parameters were not found during combined treatment of patients with ASA and clopidogrel. Strong direct correlations between MPV and GP IIb-IIIa and GP Ib contents were detected in both healthy donors and ACS patients (at all time points): the r values ranged from 0.439 to 0.647 (p ≤ 0.001 for all correlations). Genetic polymorphisms of GP IIb-IIIa (GP IIIa Leu33Pro) and GP Ib ((?5)T/C (Kozak) and Thr145Met) identified in ACS patients did not affect expression levels of corresponding glycoproteins. The data obtained indicate that increased MPV values correlate with increased platelet aggregation activity and enhanced GP IIb-IIIa and GP Ib expression.     

Quantitative trait loci for baseline white blood cell count, platelet count, and mean platelet volume

A substantial genetic contribution to baseline peripheral blood counts has been established. We performed quantitative trait locus/loci (QTL) analyses to identify chromosome (Chr) regions harboring genes influencing the baseline white blood cell (WBC) count, platelet (Plt) count, and mean platelet volume (MPV) in F₂ intercrosses between NZW/LacJ, SM/J, and C57BLKS/J inbred mice. We identified six significant WBC QTL: Wbcq1 (peak LOD score at 38 cM, Chr 1), Wbcq2 (42 cM, Chr 3), Wbcq3 (0 cM, Chr 15), Wbcq4 (58 cM, Chr 1), Wbcq5 (82 cM, Chr 1), and Wbcq6 (8 cM, Chr 14). Three significant Plt QTL were identified: Pltq1 (24 cM, Chr 2), Pltq2 (36 cM, Chr 7), and Pltq3 (10 cM, Chr 12). Two significant MPV QTL were identified, Mpvq1 (62 cM, Chr 15) and Mpvq2 (44 cM, Chr 8). In total, the WBC QTL accounted for up to 31% of the total variance in baseline WBC count, while the Plt and MPV QTL accounted for up to 30% and 49% of the total variance, respectively. These analyses underscore the genetic complexity underlying these traits in normal populations and provide the basis for future studies to identify novel genes involved in the regulation of mammalian hematopoiesis.     

Gray platelet syndrome: selective alpha-granule deficiency and thrombocytopenia due to increased platelet turnover

Clinical and laboratory studies of two siblings, both suffering from gray platelet syndrome (GPS) are described. The patients had a mild bleeding disorder, their platelets were blue-gray in panoptic stains, and alpha-granules were markedly reduced, as shown by electron microscopy. The platelet content of platelet factor 4 and that of beta-thromboglobulin were significantly reduced (3%-7% of normal). Platelet count was decreased (33-150 X 10(9)/1) and small platelets were increased in platelet volume distribution. Bleeding time was prolonged on most occasions. Bone marrow aspiration was performed in one patient and revealed increased reticulin fibers, however, megakaryocyte count was normal. The mean platelet survival was 4.8 days using 111indium-labelled platelets. In this patient, platelet-associated IgG was within the normal range. Prednisone therapy failed to increase platelet count. Dental surgery was performed under cover of desmopressin and no bleeding complication occurred; however, no improvement of bleeding time was observed. The patient delivered a healthy male infant without hemorrhaging while under concurrent platelet transfusion therapy.     

Platelet Parameters and (1, 3)-β-D-Glucan as a Diagnostic and Prognostic Marker of Invasive Fungal Disease in Preterm Infants

The diagnosis of neonatal invasive fungal disease (IFD) is difficult and often delayed. The platelet parameters and (1, 3)-β-D-Glucan (BG) may be useful for diagnosing IFD, but their diagnostic performance are not well characterized in neonates. We studied 63 preterm infants with IFD, 160 preterm infants without sepsis (preterm control), and 41 preterm infants with bacterial sepsis. Platelet parameters at the first day of onset of IFD and at the fourteenth day after antifungal treatment were evaluated. Serum BG was measured. Platelet count (PC), plateletcrit (PCT), and platelet distribution width (PDW) values were significantly lower, and mean platelet volume (MPV) values significantly higher in the IFD versus preterm control infants. PC and PCT values were much lower in infants with IFD versus bacterial sepsis, and there were significant differences in BG value between the two groups. After 14 days of antifungal treatment, significant elevations in PC, PCT, PDW and reductions in MPV levels in IFD group were observed. Receiver operating characteristic (ROC) curves showed that PC and PCT were strong predictors of IFD. The PC and PCT cut-offs for predicting IFD were 119.5 (sensitivity 78%, specificity 95%) and 0.21 (sensitivity 83%, specificity 85%), respectively. There were significant differences in PC and PCT levels between deceased and survived patients. The PC and PCT cut-offs for predicting deceased IFD were 39 (sensitivity 62%, specificity 86%) and 0.04 (sensitivity 50%, specificity 95%), respectively. The sensitivity in diagnosing IFD by a BG cutoff of ≥10pg/ml was 68.3% and specificity was 75.6%. PC and PCT levels in the BG ≥400 pg/ml group were significantly lower compared to the BG<400 pg/ml group. Platelet parameters and BG could be useful biomarkers for the diagnosis and prognosis of neonatal IFD.     

Role of Platelet Parameters on Sudden Sensorineural Hearing Loss: A Case-Control Study in Iran

Sudden sensorineural hearing loss (SSNHL) is a common otological disorder characterized by a hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours. It has been established that platelet parameters, such as mean platelet volume, are associated with ischemic heart events, whose clinical manifestations are similar to those of SSNHL. Hence, we aimed to determine if the platelet count, mean platelet volume and platelet distribution width are related to the occurrence and severity of sudden sensorineural hearing loss. A case-control prospective study was conducted in a teaching hospital in Iran. One hundred-eight patients with SSNHL and an equal number of healthy, age- and sex-matched controls were enrolled in the study. Peripheral venous blood samples were collected from the subjects, and the platelet count, mean platelet volume and platelet distribution width were measured with an automated blood cell counter. Analysis of the audiometry and hematological test results using SPSS₂₂ software showed no statistical correlation between the platelet parameters and the occurrence of SSNHL, but correlation coefficients showed a significant correlation between PDW and hearing loss severity in patients group. However, further investigation is required to unequivocally establish the absence of correlation between the platelet parameters and occurrence of SSNHL.