BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to deco...BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.展开更多
AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).
<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Platelets play a key ro...<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Platelets play a key role in the development and progression of cardiovascular diseases. Also red cell distribution width (RDW%) & platelet indices are a good predictor of clinical outcomes.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Purpose: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Study the relationship between RDW%, platelets count, mean platelet volume (MPVfl) and platelet distribution width (PDWfl) in children with congenital heart disease </span><span style="font-family:Verdana;">(CHD) or rheumatic heart diseases (RHD).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Subjects and Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> study was carried on 151 children diagnosed as CHD or RHD selected from pediatric department of Al-Zahraa University Hospital and National Heart Insti</span><span style="font-family:Verdana;">tute. They were aged from 6 months to 12 years. Another 80 apparently</span><span style="font-family:Verdana;"> healthy children were taken as controls. Complete blood count and echocardiography examination were evaluated for all participants.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The mean value of </span><span style="font-family:Verdana;">RDW% was increased in CHD and RHD than controls, RDW% higher in</span><span style="font-family:Verdana;"> cyanotic CHD (CCHD) (either decompensated or compensated) than acyanotic CHD, and in decompensated RHD than compensated RHD with more than one valve affection. The mean platelets count were decreased in cyanotic than acyanotic CHD, platelets count were increased in decompensated than </span><span style="font-family:Verdana;">compensated RHD either with one valve or more than one valve affection.</span><span style="font-family:Verdana;"> The mean values of MPV and PDW were increased in decompensated CHD, but it decreased in decompensated RHD. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The RDW%, MPV and PDW considered as simple markers in the follow up of patients with CHD or RHD for early detection of serious complication.</span></span></span></span>展开更多
Objective:To explore the diagnostic value of combined detection of myocardial markers, white blood cell (WBC) counts and platelet distribution width (PDW) in patients with positive myocardial injury markers.Methods: F...Objective:To explore the diagnostic value of combined detection of myocardial markers, white blood cell (WBC) counts and platelet distribution width (PDW) in patients with positive myocardial injury markers.Methods: From January 2017 to January 2018, 100 patients with positive markers of myocardial injury in our hospital were selected as observation group, and 100 healthy people were selected as control group. Serum myocardial markers troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (MYO), WBC count, and PDW levels were measured at admission, and analyzed for individual indicators. And individual and combined detections of these indicators in early diagnosis of acute myocardial infarction (AMI) were analysed.Results: Serum cTnI, CK-MB, MYO, WBC count and PDW level were higher in the observation group than those in the control group, and the difference between the groups was statistically significant. Of the 100 patients with positive myocardial injury markers, 48 (48.00%) were diagnosed with AMI by final clinical diagnosis. Compared with the control group, the positive rate of serum index and the combined detection of five indicators in the observation group were significantly increased. The sensitivity and specificity of the five indicators combined detection and diagnosis of AMI were 95.83% and 94.23%, respectively, which were higher than the individual detection of each index, and the difference was statistically significant.Conclusions: The combined detection of serum cTnI, CK-MB, MYO, WBC count and PDW is helpful for early diagnosis of AMI and can improve the sensitivity and specificity of diagnosis.展开更多
目的探讨血小板、凝血功能对合并2型糖尿病的脓毒症(sepsis patients with type 2 diabetes mellitus,T2DM-sepsis)患者发生急性肾损伤(acute kidney injury,AKI)的预测价值。方法选取2015年1月至2021年1月首都医科大学附属北京同仁医院...目的探讨血小板、凝血功能对合并2型糖尿病的脓毒症(sepsis patients with type 2 diabetes mellitus,T2DM-sepsis)患者发生急性肾损伤(acute kidney injury,AKI)的预测价值。方法选取2015年1月至2021年1月首都医科大学附属北京同仁医院T2DM-sepsis患者257例。根据T2DM-sepsis患者住院期间脓毒症发病7 d内是否发生AKI,将患者分为AKI组与非AKI组。收集两组患者一般资料和临床资料,采用多因素logistic回归方程分析T2DM-sepsis患者发生AKI的影响因素,并采用ROC曲线评估血小板、凝血功能对患者发生AKI的预测价值。结果257例患者中男146例、女111例,年龄32~101岁,平均(77.4±13.2)岁;发生AKI的患者34例(13.2%)。与非AKI组相比,AKI组的序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、血小板分布宽度(platelet distribution width,PDW)、血小板平均体积(mean platelet volume,MPV)、纤维蛋白原降解产物(fibrinogen degradation products,FDP)和D-二聚体(D-dimer,D-D)均较高,PLT较低,差异均有统计学意义(P<0.05)。多因素回归分析结果显示,SOFA评分越高(OR=1.300,95%CI:1.018~1.661,P=0.035)、PDW越高(OR=1.338,95%CI:1.122~1.596,P=0.001)的T2DM-sepsis患者发生AKI的风险越高。SOFA评分和PDW预测患者发生AKI的AUC分别为0.717(95%CI:0.619~0.815,P<0.001)和0.752(95%CI:0.655~0.848,P<0.001)。结论PDW值可作为T2DM-sepsis患者发生AKI风险的评估指标,临床上应特别关注PDW>12.25 fl的T2DM-sepsis患者的治疗和预后。展开更多
文摘BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.
基金Supported by Ankara Numune Education and Research Hospital
文摘AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).
文摘<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Platelets play a key role in the development and progression of cardiovascular diseases. Also red cell distribution width (RDW%) & platelet indices are a good predictor of clinical outcomes.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Purpose: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Study the relationship between RDW%, platelets count, mean platelet volume (MPVfl) and platelet distribution width (PDWfl) in children with congenital heart disease </span><span style="font-family:Verdana;">(CHD) or rheumatic heart diseases (RHD).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Subjects and Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> study was carried on 151 children diagnosed as CHD or RHD selected from pediatric department of Al-Zahraa University Hospital and National Heart Insti</span><span style="font-family:Verdana;">tute. They were aged from 6 months to 12 years. Another 80 apparently</span><span style="font-family:Verdana;"> healthy children were taken as controls. Complete blood count and echocardiography examination were evaluated for all participants.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The mean value of </span><span style="font-family:Verdana;">RDW% was increased in CHD and RHD than controls, RDW% higher in</span><span style="font-family:Verdana;"> cyanotic CHD (CCHD) (either decompensated or compensated) than acyanotic CHD, and in decompensated RHD than compensated RHD with more than one valve affection. The mean platelets count were decreased in cyanotic than acyanotic CHD, platelets count were increased in decompensated than </span><span style="font-family:Verdana;">compensated RHD either with one valve or more than one valve affection.</span><span style="font-family:Verdana;"> The mean values of MPV and PDW were increased in decompensated CHD, but it decreased in decompensated RHD. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The RDW%, MPV and PDW considered as simple markers in the follow up of patients with CHD or RHD for early detection of serious complication.</span></span></span></span>
文摘Objective:To explore the diagnostic value of combined detection of myocardial markers, white blood cell (WBC) counts and platelet distribution width (PDW) in patients with positive myocardial injury markers.Methods: From January 2017 to January 2018, 100 patients with positive markers of myocardial injury in our hospital were selected as observation group, and 100 healthy people were selected as control group. Serum myocardial markers troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (MYO), WBC count, and PDW levels were measured at admission, and analyzed for individual indicators. And individual and combined detections of these indicators in early diagnosis of acute myocardial infarction (AMI) were analysed.Results: Serum cTnI, CK-MB, MYO, WBC count and PDW level were higher in the observation group than those in the control group, and the difference between the groups was statistically significant. Of the 100 patients with positive myocardial injury markers, 48 (48.00%) were diagnosed with AMI by final clinical diagnosis. Compared with the control group, the positive rate of serum index and the combined detection of five indicators in the observation group were significantly increased. The sensitivity and specificity of the five indicators combined detection and diagnosis of AMI were 95.83% and 94.23%, respectively, which were higher than the individual detection of each index, and the difference was statistically significant.Conclusions: The combined detection of serum cTnI, CK-MB, MYO, WBC count and PDW is helpful for early diagnosis of AMI and can improve the sensitivity and specificity of diagnosis.
文摘目的探讨血小板、凝血功能对合并2型糖尿病的脓毒症(sepsis patients with type 2 diabetes mellitus,T2DM-sepsis)患者发生急性肾损伤(acute kidney injury,AKI)的预测价值。方法选取2015年1月至2021年1月首都医科大学附属北京同仁医院T2DM-sepsis患者257例。根据T2DM-sepsis患者住院期间脓毒症发病7 d内是否发生AKI,将患者分为AKI组与非AKI组。收集两组患者一般资料和临床资料,采用多因素logistic回归方程分析T2DM-sepsis患者发生AKI的影响因素,并采用ROC曲线评估血小板、凝血功能对患者发生AKI的预测价值。结果257例患者中男146例、女111例,年龄32~101岁,平均(77.4±13.2)岁;发生AKI的患者34例(13.2%)。与非AKI组相比,AKI组的序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、血小板分布宽度(platelet distribution width,PDW)、血小板平均体积(mean platelet volume,MPV)、纤维蛋白原降解产物(fibrinogen degradation products,FDP)和D-二聚体(D-dimer,D-D)均较高,PLT较低,差异均有统计学意义(P<0.05)。多因素回归分析结果显示,SOFA评分越高(OR=1.300,95%CI:1.018~1.661,P=0.035)、PDW越高(OR=1.338,95%CI:1.122~1.596,P=0.001)的T2DM-sepsis患者发生AKI的风险越高。SOFA评分和PDW预测患者发生AKI的AUC分别为0.717(95%CI:0.619~0.815,P<0.001)和0.752(95%CI:0.655~0.848,P<0.001)。结论PDW值可作为T2DM-sepsis患者发生AKI风险的评估指标,临床上应特别关注PDW>12.25 fl的T2DM-sepsis患者的治疗和预后。
文摘目的研究术前血小板分布宽度(Platelet volume distribution width,PDW)联合系统性炎症指数(Systemic inflammation response index,SIRI)对结肠癌术后复发转移的预测价值。方法以2020年1月-2021年6月江苏大学附属医院胃肠外科就诊并接受根治性切除手术治疗的194例结肠癌患者为结肠癌组,选择同期在本院体检中心招募的100例健康体检者为对照组。术前检测并记录PDW和SIRI,收集患者的一般资料包括:性别、年龄、身高、体重、家族肿瘤史、是否吸烟、酗酒、体质指数(Body mass index,BMI)、肿瘤最大径、TNM分期(Tumor node metastasis,TNM)和分化程度。对患者随访2年,记录结肠癌复发转移情况。采用ROC曲线确定相关变量的临界最佳值,通过AUC(ROC曲线下面积)评价其预后的准确性。结果与对照组比较,结肠癌组PDW和SIRI均显著增高,差异有统计学意义(P<0.05)。术后发生复发转移患者术前PDW与SIRI高于术后未发生复发转移的患者,差异有统计学意义(P<0.05)。TNM分期Ⅲ~Ⅳ期和中低分化程度术后复发转移患者的PDW高于Ⅰ~Ⅱ期患者和高分化程度患者,差异有统计学意义(P<0.05)。肿瘤最大径≥5 cm、TNM分期Ⅲ~Ⅳ期和中低分化程度术后复发转移患者的PDW高于肿瘤最大径<5 cm、TNM分期Ⅰ~Ⅱ期和高分化程度的患者,差异有统计学意义(P<0.05)。PDW、SIRI及两者联合预测结肠癌术后复发转移的曲线下面积(Area under curve,AUC)分别为0.761(95%CI:0.691~0.831),0.836(95%CI:0.775~0.897)和0.918(95%CI:0.876~0.960)。术后复发转移患者的PDW与SIRI呈显著正相关关系(r=0.574,P=0.003)。结论PDW、SIRI与结肠癌患者临床病理特征和术后复发转移有关,两者联合预测术后复发转移的效能较好,可为临床应用提供一定参考价值。