急性肺栓塞患者血小板动态变化及其与预后的相关性分析

Correlation of dynamic change of platelet and prognosis in patients with acute pulmonary embolism

目的:分析急性肺栓塞(APE)患者血小板动态变化与预后之间的相关性。方法:回顾性分析80例APE患者的临床资料,根据患者预后情况分为存活组48例与死亡组32例。所有患者均接受1周治疗,对比治疗前后两组患者血小板计数、平均血小板体积(MPV)和血小板分布宽度(PDW)及其与预后之间存在的相关性。结果:治疗前,两组患者血小板数量、MPV水平比较,差异无统计学意义(P>0.05),治疗后,存活组血小板数量、MPV水平均明显低于死亡组(P<0.05);治疗前后,存活组患者PDW水平明显低于死亡组(P<0.05)。MPV对预测预后有一定价值,可作为预测APE患者死亡的独立危险因素,治疗前MPV水平与患者死亡率呈正相关的关系,APE患者治疗前后MPV水平改变(△MPV)与患者死亡呈负相关的关系。结论:MPV水平的动态变化情况可作为APE患者疾病严重程度及死亡预测的重要因子,MPV水平的增加提示死亡风险增加。

Objective:To analyze correlation between dynamic change of platelet and prognosis of patients with acute pulmonary embolism(APE).Methods:The clinical data of 80 patients with APE were retrospectively analyzed.According to the prognosis,they were divided into survival group(48 cases)and death group(32 cases).All patients were treated for 1 week.The platelet counts,mean platelet volumes(MPV),platelet distribution widths(PDW)before and after the treatment of the two groups were compared,and the correlations among them and the patients'prognosis were analyzed.Results:Before the treatment,there was no statistical difference in the MPV level between the two groups(P>0.05);and the PDW level of the survival group was significantly lower than that of the death group(P<0.05).After the treatment,the levels of PDW and MPV in the survival group were significantly lower than those of the death group(P<0.05).MPV had certain values in predicting the prognosis of the patients,and could be taken as the independent risk factor of predicating the death of the APE patients.Moreover,the MPV level had a positive correlation with death rate before the treatment,and the changes of MPV levels(△MPV)had a negative correlation with death rate before and after the treatment.Conclusions:The dynamic change of MPV is the key factor to predict the severity and death of the APE patients and increased MPV level shows the patients with an increased risk of death.