平均血小板体积对肺栓塞复发的预测价值研究

Predictive Value of Mean Platelet Volume for Recurrence of Pulmonary Embolism

目的探究平均血小板体积(mean platelet volume,MPV)对肺栓塞(pulmonary embolism,PE)复发的预测价值研究.方法选取2010年1月~2017年1月笔者医院收治的首次发生肺栓塞的患者169例,根据肺栓塞是否复发分为复发组与未复发组,比较两组的一般资料、血液学指标及PE危险评分间的差异,COX回归模型分析患者复发的独立危险因素,应用ROC曲线评估相关指标对PE患者远期复发的预测效能.结果纳入研究的PE患者的复发率为15.44%.复发组患者的平均年龄高于未复发组(P<0.05),两组在性别、体重指数、诱因、合并基础疾病和随访时间上比较,差异均无统计学意义(P>0.05).复发组患者的PLT、PDW、MPV、FIB、DD水平及简化Wells、Geneva量表评分均显著高于未复发组(P均<0.05).多因素COX回归分析显示,MPV、DD和简化Geneva量表是PE患者发生复发的独立危险因素(HR=12.214、5.368、5.405,P<0.05).应用MPV预测PE患者复发生的AUC为0.913,显著高于DD和简化Geneva量表(Z=2.662、2.629,P<0.05).其中,MPV的最佳截点为≥10.19fl,此时其预测PE患者复发的敏感度为95.65%(22/23),特异性为84.13%(106/126).结论平均血小板体积对肺栓塞患者的复发风险具有较高的预测价值,其最佳截点为MPV≥10.19fl.

Objective To explore the predictive value of mean platelet volume(MPV)in the recurrence of pulmonary embolism(PE).Methods Totally 169 patients with pulmonary embolism were selected from January 2010 to January 2017,they were divided into recurrence group and non-recurrence group according to the recurrence of pulmonary embolism.The differences of general data,hematological parameters and PE risk score between the two groups were compared.COX regression model was used to analyze the independent risk factors of recurrence.ROC curve was used to evaluate the predictive efficacy of related indicators for long-term recurrence of PE patients.Results The recurrence rate of PE patients included in the study was 15.44%.The average age of the relapsed group was higher than that of the non-relapsed group(P<0.05).There was no significant difference in gender,body mass index,inducement,basic diseases and follow-up time between the two groups(P>0.05).The levels of P LT,PDW,MPV,FIB,DD and the scores of simplified Wells and Geneva scales in the relapsed group were significantly higher than those in the non-relapsed group(all P<0.05).Multivari?ate Cox regression showed that MPV,DD and simpliRed Geneva scale were independent risk factors for PE recurrence(HR=12.214,5.368,5.405,P<0.05).The AUC of predicting PE recurrence by MPV was 0.913,significantly higher than DD and simplified Geneva scale(Z=2.662,2.629,P<0.05).The best cut-off point of MPV was ≥10.19fl.The sensitivity and specificity of MPV for predicting PE recurrence were 95.65%(22/23)and 84.13%(106/126).Conclusion Average platelet volume has a high predictive value for recurrence risk in patients with pulmonary embolism.The best cut-off point is MPV≥10.19fl.