Changes Of Platelet Parameter And D-dimer In Children With Henoch-sch(?)nlein Purpura And Clinical Significance

Objective To investigate the difference of the platelet parameter and D-dimer in hospitalized children with Henoch-Sch?nlein purpura(HSP), and to assess the value of them in estimate the disease status and prognosis. Methods 151 hospitalized children with HSP were recuited from March 2013 to December 2015 in the First Affiliated Hosptial of Fujian Medical University were examined the platelet parameter and D-dimer of peripheral blood. They were divided into three groups based on types of renal damage named non-renal involvement group, isolated hematuria group and HSP nephritis group. Platelet parameters were detected by Japanese SYSMEX XS800 I blood cell analyzer, and D-dimer by Japanese SYSMEX CS5100 automatic blood coagulation. SPSS 22 statistical software was used in all statistical tests. Single factor analysis of variance, multivariate analysis of covariance and linear regression analysis were used to compare the difference of platelet parameter and D-dimer of peripheral blood among the three groups. The value of ?=0.05 was considered significant. Results There were 101 children with HSP in non-renal involvement group, 26 in isolated hematuria group and 24 in HSP nephritis group. The blood platelet counts(BPC, ×109/L) in non-renal involvement group, isolated hematuria group and HSP nephritis group were(347.1±98.9),(372.1±114.3) and(318.9±78.9), mean platelet volume(MPV, fl) were(9.99±1.03),(9.75±1.17) and(9.41±0.78), platelet distribution width(PDW, fl) were(11.54±2.05),(11.23±2.54) and(10.38±1.38), platelet hematocrit(PCT, %) were(0.34±0.08),(0.36±0.09) and(0.30±0.08), respectively. The D-dimer content(mg/L) in non-renal involvement group, isolated hematuria group and HSP nephritis group were(3.45±3.44),(2.75±3.27) and(2.40±4.04) respectively. Analysis of variance indicated that MPV and PDW were significant difference among the three groups(F was respectively 3.26, 3.12, and P was respectively 0.041, 0.047); There were no statistically significant difference in BPC, PCT and D-dimer content among the three groups(F was respectively 2.98, 1.09, 0.168 and P was respectively 0.054, 0.339, 1.81). Covariance showed that after controlling the effect of granulocyte and lymphocyte counts of peripheral blood, HSP nephritis group still had lower MPV compared with non-renal involvement group significantly(P=0.007). After controlling the effect of glucocorticoid treatment, granulocyte and lymphocyte counts of peripheral blood before admission, PDW were significantly lower in HSP nephritis group than the non-renal involvement HSP group(P=0.043). Multiple linear stepwise regression analyzed showed that blood MPV could be influenced by neutrophil counts, renal involvement and lymphocyte counts, and the degree of renal involvement was significantly negative correlation with MPV(?=-0.29, P= 0.007); blood PDW could be influenced by glucocorticoid treatment, granulocyte counts of peripheral blood and renal involvement before admission, and the degree of renal involvement was significantly negative correlation with PDW(?=-0.45, P=0.037). Conclusion Decreases in MPV, PDW of peripheral blood were associated with renal involvement of HSP patients, which could be used as a reference index of the disease status and prognosis in HSP.