Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding

Lowe Gillian C.; Fickowska Roksana; Al Ghaithi Rashid; Maclachlan Annabel; Harrison Paul; Lester Will; Watson Steve P.; Myers Bethan; Clark Justin; Morgan Neil V

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Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding

机译：患有未解释的大重月经出血妇女底层血小板缺陷的贡献

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Heavy menstrual bleeding (HMB) is often undiagnosed in women and can cause discomfort and distress. A haemostatic cause for excessive bleeding is often not routinely investigated and can lead to hysterectomy at an early age. A prospective cohort study was carried out to determine whether certain patients with unexplained HMB have an underlying platelet function defect (PFD). The Genotyping and Phenotyping of Platelets (GAPP) study recruited 175 women with HMB and 44 unrelated volunteers from 25 Haemophilia Centres across the UK, and a tertiary gynaecology service. Bleeding history was assessed using the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH-BAT). Platelet count, platelet size, haemoglobin and mean corpuscular volume were measured in whole blood using the Sysmex XN-1000 Haematology Analyzer. Platelet function testing using lumiaggregometry and flow cytometry was performed in patients included in this study. A PFD was identified in 47% (82/175) of patients with HMB. Cutaneous bleeding was the most frequent additional bleeding symptom (89% in PFD and 83% with no PFD). Whole blood platelet count was significantly lower (P 0.0001) between the PFD group and no PFD group. The prevalence of anaemia did not differ between patients and healthy volunteers. Clinical evaluation alone is insufficient to determine presence of an underlying PFD in patients with HMB. Platelet function tests may be considered and clinical guidelines may include them in their algorithms. An appropriate diagnosis and subsequent tailored management of HMB may prevent unnecessary surgery and help manage future haemostatic challenges.

机译：女性往往没有造成不适和痛苦的重症月经出血（HMB）。过度出血的血压原因通常不会常规研究，并且可以在休眠中导致子宫切除术。进行了预期队列研究以确定某些未解释的HMB患者是否具有潜在的血小板函数缺陷（PFD）。血小板（GAPP）研究的基因分型和表型招募了175名妇女的患有HMB和44个来自英国的25个血糖中心的妇女，以及第三次妇科服务。利用国际血栓形成和肿瘤出血评估工具（ISTH-BAT）的国际社会评估出血历史。使用Sysmex XN-1000血液分析仪在全血中测量血小板计数，血小板尺寸，血红蛋白和平均碎石体积。使用Lumgagreg测定和流式细胞术进行血小板功能测试在本研究中的患者中进行。在47％（82/175）的HMB患者中鉴定了PFD。皮肤出血是最常见的额外出血症状（PFD 89％，83％，没有PFD）。 PFD组和无PFD组之间的全血小板计数显着降低（P <0.0001）。贫血的患病率没有患者与健康志愿者之间的不同。单独的临床评估不足以确定HMB患者的潜在PFD的存在。可以考虑血小板功能测试，并且临床指南可以在其算法中包括它们。适当的诊断和随后的HMB定制管理可能会防止不必要的手术，并有助于管理未来的止血挑战。

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来源
《Platelets》 |2019年第1期|共10页
作者
Lowe Gillian C.; Fickowska Roksana; Al Ghaithi Rashid; Maclachlan Annabel; Harrison Paul; Lester Will; Watson Steve P.; Myers Bethan; Clark Justin; Morgan Neil V;
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作者单位

Univ Hosp Birmingham NHS Fdn Trust Comprehens Care Haemophilia Ctr Birmingham W Midlands England;

Univ Birmingham Coll Med &

Dent Sci Inst Cardiovasc Sci Birmingham B15 2TT W Midlands England;

Univ Birmingham Coll Med &

Dent Sci Inst Inflammat &

Ageing Birmingham W Midlands England;

Univ Birmingham Coll Med &

Dent Sci Inst Cardiovasc Sci Birmingham B15 2TT W Midlands England;

Univ Birmingham Coll Med &

Dent Sci Inst Inflammat &

Ageing Birmingham W Midlands England;

Univ Hosp Birmingham NHS Fdn Trust Comprehens Care Haemophilia Ctr Birmingham W Midlands England;

Univ Birmingham Coll Med &

Dent Sci Inst Cardiovasc Sci Birmingham B15 2TT W Midlands England;

Lincoln Cty Hosp Dept Haematol Lincoln England;

Birmingham Womens &

Childrens NHS Fdn Trust Dept Gynaecol Birmingham W Midlands England;

Univ Birmingham Coll Med &

Dent Sci Inst Cardiovasc Sci Birmingham B15 2TT W Midlands England;

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原文格式 PDF
正文语种 eng
中图分类基础医学;
关键词
Aggregometry; bleeding; heavy menstrual bleeding; platelet function defects; platelet function tests; platelets;

机译：聚体;出血;大量月经出血;血小板函数缺陷;血小板函数测试;血小板;

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专利

1. Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding [J] . Lowe Gillian C., Fickowska Roksana, Al Ghaithi Rashid, Platelets . 2019,第1期

机译：患有未解释的大重月经出血妇女底层血小板缺陷的贡献
2. THE MAJORITY OF WOMEN WITH UNEXPLAINED HEAVY MENSTRUAL BLEEDING HAS REDUCED THROMBIN GENERATION AND/OR DECREASED PLATELET RESPONSE. [J] . Roest Mark, Eising Heleen, de Groot Philip, International journal of laboratory hematology . 2016,第6期

机译：大量女性因经期出血过多而减少了凝血酶的产生和/或血小板反应减少。
3. Platelet function defects in adolescents with heavy menstrual bleeding [J] . MillsH.L., Abdel-BakiM.S., TeruyaJ., Haemophilia: the official journal of the World Federation of Hemophilia . 2014,第2期

机译：月经大量出血的青少年的血小板功能缺陷
4. An Investigation of the Contribution of Heaviness to Models of Annoyance for Sonic Booms and Other Impulsive Sounds [C] . Daniel Carr, Patricia Davies National conference on noise control engineering . 2019

机译：重量对声波动臂和其他脉冲声音烦恼模型的贡献的调查
5. Sense of belonging among women of color in science, technology, engineering, and math majors: Investigating the contributions of campus racial climate perceptions and other college environments [D] . Johnson, Dawn Rene 2007

机译：科学，技术，工程和数学专业的有色女性中的归属感：调查校园种族气候观念和其他大学环境的贡献
6. Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding [O] . Gillian C. Lowe, Roksana Fickowska, Rashid Al Ghaithi, -1

机译：女性原因不明的严重经血中潜在的血小板缺陷的影响的调查
7. Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding [O] . Gillian C. Lowe, Roksana Fickowska, Rashid Al Ghaithi, 2018

机译：对未解释的重重经济出血妇女底层血小板缺陷的贡献调查

Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding

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