D-二聚体、纤维蛋白原联合血小板计数对缺血性脑卒中的诊断价值研究

Changes and clinical significance of PLT,D-dimer and bone marrow megakaryocyte count levels in patients with thrombocytopenic purpura

目的:研究D-二聚体(DD)、纤维蛋白原(FIB)联合血小板计数(PLT)对缺血性脑卒中的诊断价值。方法:选取收治的60例缺血性中风患者为观察组,再选取同期体检中心行健康体检者60例为对照组。检测两组人员血清DD、FIB及PLT等指标水平,采用Logistic回归筛选缺血性中风的独立危险因素,分析DD、FIB和PLT与缺血性中风的相关性,并绘制DD、FIB、PLT联合检测的ROC曲线。结果:①一般资料分析显示,两组人员性别、年龄、BMI、饮酒、吸烟、心脏病史、糖尿病史、高血压史、脑血管疾病史、肝脏疾病史等资料,差异均无统计学意义(P>0.05);两组人员DD、FIB、PLT等指标比较差异有统计学意义(P<0.05);②基于多因素Logistic回归分析,DD、FIB及PLT是引起缺血性脑卒中的独立危险因素,差异有统计学意义(P<0.05);③DD、FIB、PLT及联合检测判断缺血性脑卒中的ROC曲线分析结果显示:DD、FIB和PLT的AUC分别为0.738、0.641和0.688,而联合检测的AUC是0.837,相比于单个指标明显提升,差异有统计学意义(P<0.05)。结论:缺血性脑卒中患者的血清DD、FIB和PLT等表达会异常升高,其联合检测的AUC明显更高于单个指标的检测,可对病情程度作出有效判断,故联合检测血清DD、FIB和PLT表达能为临床诊断及判定病情进展提供指导,有利于医务人员及时制定相关防治方案。

Objective To investigate the changes and clinical significance of PLT,D-dimer and bone marrow megakaryocyte counts in patients with thrombocytopenic purpura.Method 42 patients with thrombocytopenic purpura who entered our hospital for diagnosis and treatment were selected as the study group,and 42 healthy subjects were collected as the control group.Detect the platelet count(PLT),D-dimer and bone marrow megakaryocyte count levels of the two groups of people,use Logistic regression to screen the risk factors of thrombocytopenic purpura,and plot the combination of PLT,D-dimer,and bone marrow megakaryocyte counts Detect the ROC curve of thrombocytopenic purpura.Results The PLT of the study group was lower than that of the control group,while the counts of D-dimer,bone marrow megakaryocytes were higher than that of the control group(P<0.05).The results of general data analysis showed that there was no statistical difference between the study group and the control group in data such as age,gender,body mass index and place of residence(P>0.05),while statistics such as PLT,D-dimer,and bone marrow megakaryocyte counts existed.Academic difference(P<0.05).The results of multivariate logistic regression analysis showed that PLT,D-dimer,and bone marrow megakaryocyte count were the influencing factors of thrombocytopenic purpura(P<0.05).The results of ROC curve analysis of PLT,D-dimer,and bone marrow megakaryocyte count combined to detect thrombocytopenic purpura showed that the combined The detected AUC was significantly improved compared to a single index,and the results are statistically different(P<0.05).The sensitivity and specificity of the combined detection were better than a single index detection(P<0.05).Conclusion PLT,D-dimer,bone marrow megakaryocyte count,etc.are the influencing factors of thrombocytopenic purpura,and the combined detection efficiency of PLT,D-dimer,and bone marrow megakaryocyte count is better than the detection efficiency of thrombocytopenic purpura alone Detection.