血液学相关参数评估急性肺栓塞危险分层的价值

The value of hematologic parameters in evaluating risk stratification of acute pulmonary embolism

目的探讨血液学相关参数评估急性肺栓塞危险分层的价值。方法选取2019年1月至2021年6月衢州市人民医院收治的183例急性肺栓塞患者为研究对象,危险分层评估为中高危(中高危组)67例,低危(低危组)116例。比较不同危险分层患者血液学相关参数,采用多因素logistic回归分析急性肺栓塞危险分层的独立影响因素,采用ROC曲线分析血液学相关参数对中高危急性肺栓塞的评估效能。结果中高危组患者纤维蛋白原、血小板计数均明显低于低危组,D-二聚体、红细胞计数、血小板分布宽度均明显高于低危组,差异均有统计学意义(均P<0.05);不同危险分层患者血红蛋白、平均红细胞体积、红细胞压积、平均红细胞血红蛋白、红细胞分布宽度、平均血小板体积、大血小板比率比较,差异均无统计学意义(均P>0.05)。纤维蛋白原(OR=0.990)、D-二聚体(OR=12.843)、红细胞计数(OR=1.626)、血小板计数(OR=0.986)、血小板分布宽度(OR=1.199)是急性肺栓塞危险分层的独立影响因素(均P<0.05)。纤维蛋白原、D-二聚体、红细胞计数、血小板计数、血小板分布宽度评估中高危急性肺栓塞的AUC分别为0.661、0.751、0.643、0.789、0.624。结论纤维蛋白原、D-二聚体、红细胞计数、血小板计数、血小板分布宽度等血液学相关参数对急性肺栓塞危险分层具有一定的评估价值,可作为临床辅助检查手段。

Objective To explore the value of hematologic parameters in evaluating the risk stratification of acute pulmonary embolism.Methods A total of 183 patients with acute pulmonary embolism admitted to Quzhou People's Hospital from January 2019 to June 2021 were selected.The risk stratification evaluation was 67 cases of medium and high risk(medium and high risk group)and 116 cases of low risk(low risk group).The hematological parameters of patients with different risk stratification were compared,and the independent influencing factors of risk stratification of acute pulmonary embolism were analyzed by multivariate logistic regression,and the value of hematological parameters in the evaluation of high-risk acute pulmonary embolism was analyzed by ROC curve.Results The fibrinogen and platelet counts of the middle and high-risk groups were significantly lower than those of the low-risk group(both P<0.05),while the D-dimer,red blood cell(RBC)count and platelet distribution width of the high-risk group were significantly higher than those of the low-risk group(all P<0.05).There were no significant differences in hemoglobin,mean corpuscular volume,hematocrit,mean corpuscular hemoglobin,RBC distribution width,mean platelet volume and large platelet ratio among patients with different risk stratification(all P>0.05).Fibrinogen(OR=0.990),D-dimer(OR=12.843),red blood cell count(OR=1.626),platelet count(OR=0.986)and platelet distribution width(OR=1.199)were significantly correlated with the risk stratification of acute pulmonary embolism(all P<0.05).The AUCs of fibrinogen,D-dimer,RBC count,platelet count and platelet distribution width to assess high-risk acute pulmonary embolism were 0.661,0.751,0.643,0.789 and 0.624,respectively.Conclusion Hematologic parameters such as fibrinogen,D-dimer,RBC count,platelet count and platelet distribution width have certain evaluation value for the risk stratification of acute pulmonary embolism and can be used as clinical auxiliary examination methods.