平均血小板体积评价急性缺血性脑卒中静脉溶栓患者短期预后的价值研究

Value of Mean Platelet Volume in Evaluating Short-term Outcome of Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

目的研究平均血小板体积(MPV)评价急性缺血性脑卒中(AIS)静脉溶栓患者短期预后的应用价值。方法连续选取AIS静脉溶栓患者121例,根据发病后14 d或出院时改良Rankin量表(mRS)评分,分为短期预后良好组(mRS≤2分),短期预后不良组(mRS≥3分)。比较两组患者的人口学特征、实验室检查和临床资料。应用多因素二元Logistic回归分析短期预后不良的独立危险因素,采用受试者工作特征(ROC)曲线评价MPV对短期预后的预测价值。结果短期预后良好组的MPV明显低于短期预后不良组[(9.61±1.28)f L对比(10.30±1.24)fL,P<0.05];多因素二元Logistic回归分析结果显示MPV是AIS静脉溶栓患者短期预后的独立危险因素(OR=1.735,95%CI:1.134~2.654)。ROC分析显示,MPV最佳截断点为9.82 fL,MPV预测AIS静脉溶栓患者短期不良结局的敏感度为62.8%,特异度为65.4%。结论MPV是AIS静脉溶栓患者短期预后不良的独立预测因素,具有一定的预后评定价值。

Aim To investigate the application value of mean platelet volume(MPV)in evaluating short-term outcome of acute ischemic stroke(AIS)patients treated with intravenous thrombolysis.Methods A total of 121 AIS patients treated with intravenous thrombolysis were consecutively selected and divided into good short-term outcome group(mRS≤2)and poor short-term outcome group(mRS≥3)according to the modified Rankin Scale(mRS)score at 14 d after onset or discharge.Demographic characteristics,laboratory tests,and clinical data were compared between the two groups.Multivariate binary Logistic regression was used to analyze the independent risk factors for poor short-term outcome.The predictive value of MPV for short-term outcomes was evaluated by receiver operating characteristic(ROC)curve.Results MPV in good short-term outcome group was significantly lower than that in poor short-term outcome group[(9.61±1.28)fL vs.(10.30±1.24)fL,P<0.05],and multivariate binary Logistic regression analysis showed that MPV was an independent risk factor for the short-term outcomes of AIS patientstreated with intravenous thrombolysis(OR=1.735,95%CI:1.134-2.654).ROC analysis showed that the optimal cutoff point of MPV was 9.82 f L,and MPV had a sensitivity of 62.8%and a specificity of 65.4%in predicting short-term poor outcomes of AIS patients treated with intravenous thrombolysis.Conclusion MPV is an independent predictor of poor short-term outcome in AIS patients treated with intravenous thrombolysis and has a certain prognostic value.