Тромбоцитарные индексы и их прогностическая значимость у больных хроническим гепатитом С

Abstract

The purpose — to determine the role of platelet count (Tr) and platelet indices — average platelet volume (MPV), platelet distribution width (PDW) in the prognostic significance of the activity of the infectious process in patients with chronic hepatitis C (CHC). Material and methods. 310 CHC patients were under observation. The patients were divided into groups, depending on the number Tr in the phases of disseminated intravascular coagulation (DIC). The first group corresponded to the hypercoagulation phase (Tr > 330 x 109/l, n = 22); the second to the intermediate phase (Tr 330–200 x 109/l, n = 132), the third to hypocoagulation (Tr < 200 x 109/l, n = 91). A group of patients with liver cirrhosis (n = 65), class A (n = 54), class B (n = 11) by Child — Turcotte — Pugh was studied separately. The Tr number and platelet indices PDW and MPV were determined as part of a routine blood test using an automatic analyzer XN-20 (SYSMEX, Japan). Results. The most significant changes in platelet counts were in patients in the phase of hypocoagulation and with liver cirrhosis in comparison with other groups of patients – intermediate phase and hypercoagulation in the form of their growth. In all groups, according to the phases of DIC syndrome, the fibrosis level was lower (p=0.00) compared with patients with liver cirrhosis. Against this background, there was a parallel increase in platelet counts. This confirmed the presence of an inverse correlation between the number of blood plates and the level of liver tissue fibrosis, as well as a direct correlation between the values of platelet parameters: PDW and fibrosis; MPV and fibrosis. An inverse correlation was found between blood platelets and platelet indices PDW and MPV, as well as a direct correlation between PDW and MPV indices. Conclusion. Platelet counts (RDW, MPV) in patients with CHC had an inverse correlation with the number of blood plates and a direct correlation with fibrosis and with each other. The Tr number and platelet indices (RDW, MPV) reflect the activity of the infectious process, which allows using them to predict the course of the disease under the long-term infection with hepatitis C virus.