血小板平均体积与老年社区获得性肺炎近期预后的相关性分析

Relevant research of mean platelet volume and recent prognosis of elderly patients with community acquired pneumonia patients

目的探讨入血小板平均体积(MPV)与老年社区获得性肺炎(CAP)近期预后的关系。方法选取2012年1月至2014年6月我院收治的108例老年CAP患者为研究对象,检测所有患者入院时的MPV、CRP、血常规中WBC计数及中性粒细胞百分比(PMN%)以及血气指标,并记录患者的APACHEⅡ评分等;按照老年CAP患者不同病情程度以及预后情况进行相关分组,比较各组间的MPV、CRP、WBC计数、PMN%及血气指标的差异,并应用Logistic回归模型分析老年CAP患者近期预后的危险因素。结果与非重症组比较,重症组MPV、CRP、WBC计数、PMN%、Plt计数、APACHEⅡ评分显著增高(P<0.05)、Pa O2及氧合指数降低(P<0.05);与生存组比较,死亡组亦MPV升高(P<0.05);MPV>11.215 fl的患者分组中的重症CAP患者及30 d死亡患者的比例明显高于MPV≤11.215 fl分组患者(P<0.05);经pearson相关分析显示:MPV与WBC计数、CRP、PMN%、APACHEⅡ评分呈正相关,而与氧合指数呈负相关;多因素Logistic回归分析显示:MPV(OR=1.605,P<0.05)是老年CAP患者近期预后不良的高危因素。结论血小板平均体积与老年CAP患者病情程度及近期预后密切相关,高水平MPV可能是老年CAP患者近期预后不良的高危因素。

Objective To explore the correlation between mean platelet volume and recent prognosis of eld-erly patients with community acquired pneumonia.Methods 1 08 CAP patients were selected as research subjects, and their MPV,CRP,blood routine and blood gas analysis were detected.The score of APACHEⅡ was also recor-ded.All patients were divided into different groups according to different severity and recent prognosis.The risk fac-tors influencing recent prognosis were assessed by logistic regression analysis.Results Compared with the non-se-vere group,the levels of MPV,CRP,WBC,PMN%,Plt and APACHEⅡscore increased and the levels of PaO2 and oxygenation index decreased obviously in the severe group （P〈0.05 ）.Compared with the survival group,the level of MPV increased significantly in the death group （P〈0.05 ）.There were more severe patients and higher mortality while the level of MPV was higher than 1 1 .21 5 fl.Pearson correlation analysis showed that the level of MPV was pos-itively correlated with WBC,CRP,PMN%,and APACHEⅡscore,and it was negatively correlated with oxygenation index.Multi-factor logistic regression analysis showed that MPV was independent predictors of recent prognosis in CAP patients （OR=1.605 ,P〈0.05 ）.Conclusion MPV is closely related to the severity and prognosis of elderly patients with CAP,and the level of MPV is an high risk for recent prognosis of elderly patients with CAP.