血小板分布宽度与系统性红斑狼疮相关肺动脉高压患者预后的相关性

Relationship Between Platelet Distribution Width and the Prognosis of Patients with Systemic Lupus Erythematosus-Associated Pulmonary Arterial Hypertension

目的 探讨血小板分布宽度(PDW)水平与系统性红斑狼疮相关肺动脉高压(SLE-PAH)预后的相关性。方法 回顾性分析2014年7月至2021年6月于郑州大学第一附属医院出院诊断为SLE-PAH患者的临床资料并对患者进行随访。采用单因素及多因素Cox比例风险模型评价PDW与SLE-PAH预后的关系。结果 共纳入163例SLE-PAH患者,其中28例患者死亡。根据受试者工作特征(ROC)曲线确定PDW最佳截断值为17.4 fL,PDW≥17.4 fL患者整体生存率低于PDW<17.4 fL患者(P<0.05)。单因素Cox回归分析显示,PDW≥17.4 fL患者死亡风险更高(HR:3.734,95%CI:1.757~7.937,P=0.001),校正混杂因素后,PDW≥17.4 fL仍与患者不良预后显著相关(模型1的HR:3.879,95%CI:1.813~8.300,P<0.001;模型2的HR:3.551,95%CI:1.386~9.099,P=0.008;模型3的HR:3.354,95%CI:1.238~9.002,P=0.016)。结论 PDW≥17.4 fL是SLE-PAH患者死亡的独立危险因素。

Objective To explore the relationship between platelet distribution width(PDW)level and prognosis of systemic lupus erythematosus-associated pulmonary arterial hypertension(SLE-PAH).Methods The clinical data of SLE-PAH patients discharged in the First Affiliated Hospital of Zhengzhou University from July 2014 to June 2021 were retrospectively analyzed and the patients were followed up.The relationship between PDW and the prognosis of SLE-PAH was evaluated by univariate and multivariate Cox proportional hazard models.Results A total of 163 SLE-PAH patients were included,of which 28 patients died.According to the receiver operating characteristic(ROC)curve,the optimal cut-off value of PDW was 17.4 fL.The overall survival rate of patients with PDW≥17.4 fL was lower than patients with PDW<17.4 fL(P<0.05).Univariate Cox regression analysis showed PDW≥17.4 fL patients had a higher risk of death(HR:3.734,95%CI:1.757-7.937,P=0.001).After adjustment for confounding factors,PDW≥17.4 fL was still strongly correlated with poor prognosis of patients(Model 1,HR:3.879,95%CI:1.813-8.300,P<0.001.Model 2,HR:3.551,95%CI:1.386-9.099,P=0.008.Model 3,HR:3.354,95%CI:1.238-9.002,P=0.016).Conclusion PDW≥17.4 fL is an independent risk factor for death in SLE-PAH patients.