Predictive Effect of Mean Platelet Volume in Patients with Portal Vein Thrombosis： A Meta-analysis of Case-control Studies

Mean platelet volume （MPV） is an early marker ofplatelet activation. Larger platelets, compared to small ones, increase platelet adhesion and aggregation, and present a higher thrombotic activity. Some studies have explored the association between MPV and the morbidity of portal vein thrombosis （PVT）. The aim of this study was to evaluate the predictive effect of MPV in patients with PVT by a meta-analysis. We searched Pubmed, Web of Science, SCOPUS, OVID, CNKI and CBMD from database inception to September 13, 2017. Seven studies in accordance with selection criteria were included. The extraction of basic data was independently conducted by two reviewers. The mean difference in MPV between PVT patients and controls were pooled with weighted mean difference （WMD） and 95% confidence interval of 0.88 fl （95% CI： 0.61-1.15）. A random-effect model was chosen for an obvious heterogeneity in the pooling （Chi-square=27.12, df=6, P〈0.0001, F=77.9%）. The sources of heterogeneity were from the difference of primary disease of participants and portal vein diameter. Taken together, our results reveal that MPV is a predictive indicator in patients with PVT.

Ratio of mean platelet volume to platelet count is a potential surrogate marker predicting liver cirrhosis

AIM To provide a simple surrogate marker predictive of liver cirrhosis(LC).METHODS Specimens from 302 patients who underwent resection for hepatocellular carcinoma between January 2006 and December 2012 were retrospectively analyzed. Based on pathologic findings, patients were divided into groups based on whether or not they had LC. Parameters associated with hepatic functional reserve were compared in these two groups using MannWhitney U-test for univariate analysis. Factors differing significantly in univariate analyses were entered into multivariate logistic regression analysis.RESULTS There were significant differences between the LC group(n = 100) and non-LC group(n = 202) in prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, cholinesterase, type Ⅳ collagen, hyaluronic acid, indocyanine green retention rate at 15 min, maximal removal rate of technitium-99 m diethylene triamine pentaacetic acid-galactosyl human serum albumin and ratio of mean platelet volume to platelet count(MPV/PLT). Multivariate analysis showed that prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin and hyaluronic acid, and MPV/PLT ratio were factors independently predictive of LC. The area under the curve value for MPV/PLT was 0.78,with a 0.8 cutoff value having a sensitivity of 65% and a specificity of 78%.CONCLUSION The MPV/PLT ratio, which can be determined simply from the complete blood count, may be a simple surrogate marker predicting LC.

Lower mean platelet volume is a risk indicator of hepatocellular carcinoma recurrence following liver transplantation

Background: Lower mean platelet volume(MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patients with hepatocellular carcinoma(HCC) following liver transplantation(LT). Methods: The demographic and clinical characteristics of 304 HCC patients following LT were retrieved from an LT database. All the patients were divided into the normal and lower MPV groups according to the median MPV. The factors were first analyzed using a Kaplan–Meier survival analysis, then the factors with P < 0.10 were selected for multivariate Cox regression analysis and were used to define the independent risk factors for poor prognosis. Results: The 1-, 3-, and 5-year tumor free survival was 95.34%, 74.67% and 69.29% in the normal MPV group, respectively, and 95.40%, 59.97% and 42.94% in the lower MPV group, respectively( P < 0.01). No significant difference was observed in post-LT complications between the normal and lower MPV groups. Portal vein tumor thrombosis(PVTT)[hazard ratio(HR = 2.24;95% confidence interval: 1.46–3.43;P < 0.01) and lower MPV(HR = 1.58;95% confidence interval: 1.05–2.36;P = 0.03) were identified as independent prognostic risk factors for recipient survival. Conclusion: Preoperative lower MPV is a risk indicator of HCC patients survival outcomes after LT.

Elevated Vascular Endothelial Growth Factor Level in Association with Mean Platelet Volume Are Emerging Risk Factors for Vascular Complications in T2DM Patients

Increasing evidence in both experimental and clinical studies suggests oxidative stress (OS) plays a major role in the pathogenesis of type 2 diabetes mellitus and its complications. In a physiological condition, appropriate levels of ROS, generated either in restricted amounts or transient fashion, are required to promote physiological angiogenesis and homeostatic maintenance of healthy vasculature. Uncontrolled continuous ROS production will ultimately contribute to pathology and cause tissue damage. One of the most important proangiogenic factors is vascular endothelial growth factor (VEGF) which plays a key role in diabetic endothelial dysfunction, which ultimately leads to pathogenesis of vascular complications. As VEGF is released by activated platelets, hence platelet activation could be the source of VEGF in plasma samples. Increased platelet activity is emphasized to play a role in the development of vascular complications in T2DM patients and platelet volume, a marker of the platelet function and activation, is measured as mean platelet volume (MPV). Therefore, we aimed to investigate the association between plasma VEGF levels and MPV levels that may lead to vascular complications. A case-control study of one hundred patients with T2DM (n = 100) and thirty control subjects (n = 30) were screened from different areas of West Bengal. All procedures were done with the informed consent of participants. Elevated VEGF level was found in T2DM patients (526.8 ± 34.3 pg/ml) compared to healthy controls (317.9 ± 12.9 pg/ml) which was statistically significant. T2DM patients had higher MPV (12.5 ± 0.2 fl) compared to controls (11.4 ± 0.2 fl). Thus the present study showed a significant association between VEGF level in plasma and MPV indicating the severity of vascular complications. Hence, in conclusion, it suggested that VEGF levels along with MPV are a reliable biomarker for evaluating the development and progression of vascular complications.

Mean Platelet Volume and Prognosis of Unstable Angina

Objective: Clopidogrel therapy is the standard of care in patients with unstable angina. However, a percentage of subjects are nonresponders to clopidogrel and this leads to increased adverse outcome. On the other way round, some responsive patients are exposed to bleeding complications. Detection of both in daily practice is important in order to tailor the treatment protocol. In this study we aimed to estimate the cutoff value of mean platelet volume (MPV) for both platelet responsiveness and bleeding risks. Methods: The study was planned as a prospective cohort study. A total number of 230 patients admitted to our CCU with unstable angina over a period of one year (from June 2013 to May 2014) were enrolled. Exclusion criteria were: severe anemia, throm-bocytopenia, myelodysplastic syndrome, coagulopathy and recent blood transfusion. In all patients clopidogrel was initially started and maintained during the hospital stay. Blood (2 ml) was collected in dipotassium EDTA tubes from all patients on the first day of admission by a clean puncture. Samples for MPV analysis were drawn on admission, and analyzed within 1 hour of admission after sampling by Beckman Caulter LH 780 Analyzer. Grouping was then done according to MPV of the patients into group (I) who had a low MPV less than or equal to 7.00 fl, and group (II) with MPV equal to or higher than 9.00 fl. Demographical and clinical variables of the patients were recorded. Routine laboratory parameters were also recorded. Clinical manifestations during the admission period were meticulously reported. Major complications as bleeding or, urgent need for percutaneous coronary intervention (PCI) were also studied. Results: Among the 230 patients analyzed, 175 patients (76%) were found to have MPV ≤7.00 fl (group (I)) and 55 patients (24%) had MPV ≥9.00 fl (group (II)) with mean ± SD MPV (8.4 ± 1.5 fl, vs 11.7 ± 1.2 fl respectively) (p < 0.001). Observation of clinical course during admission period revealed a statistically more significant clinical deterioration in group (II) than group (I) and the presence of more frequent AMI cases in group (II) having a high MPV. A high cutoff value of 9.7 fl for MPV was detected in prediction of clopidogrel nonresponsiveness (group (II)) with a sensitivity of 78.2% and specificity of 66.8%, and a low cutoff value for bleeding tendency lower than 6.3 fl was detected in group (I) with a sensitivity of 71.4% and specificity of 62.5%. Conclusion: This study showed that MPV can be used as a simple bedside predictor for detection of clopidogrel response in patients with unstable angina. And a cutoff value for both platelet responsiveness and risk of bleeding is now reached. This may lead to enhancement in our decision for early intervention and attention for bleeding risk during clopidogrel therapy.

Mean Platelet Volume as an Inflammation Marker, Possible Biomarker of Tumor Detection in Prostate Biopsy

Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate biopsy in predicting the results of pathology. Transrectal ultrasound-guided biopsy of the prostate was performed because of high PSA values and compared values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided prostate biopsies between January 2008 and January 2018 have been evaluated retrospectively. Patients were divided into groups according to the biopsy pathology results by benign (group 1), atypical small acinar proliferation (ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients (25.98%) were included in the study by systematic sampling. Before the biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell (WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC), neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and compared in all groups. Differences in continuous variables were assessed using the ANOVA. Logistic regression was used to analyze the linear relationship between predictive variables and pathology results. P < 0.05 was considered statistically significant. Results: NLR and PLR values were lower in group 1 than group 2 and were found statistically significant between in group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found 1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathologies. Although there was statistically significant increase in MPV values in logistic regression results, no statistically significant diagnostic value was found. In addition MPV value was found 0.5 times higher in patients who were diagnosed patients with ASAP than prostate cancer group. ROC analysis showed that the optimal threshold was 7.65 femtoliter (sensitivity: 51%;specificity: 30%) and was found to be a statistically significant diagnostic value to distinguish groups 2 and 3. The lowest value of MPV was found in group 3. Conclusions: In cases where the PSA value is insufficient in predicting the pathology result, the effect of NLR, PLR and MPV on differential diagnosis can be kept in mind. While NLR and PLR are more useful in the diagnosis of ASAP, MPV is more effective in the diagnosis of malignancy.

血小板及相关参数在初治弥漫大B细胞淋巴瘤临床分期及预后中的价值

目的:探讨血小板计数(PLT)、血小板分布宽度(PDW)、血小板平均体积(MPV)及血小板/淋巴细胞比值(PLR)在弥漫大B细胞淋巴瘤(DLBCL)患者临床分期及预后的价值。方法:回顾性分析60例病理诊断为DLBCL患者(观察组)的临床资料及随访信息,同时选取60例同期健康体检者作为对照组,采集所有研究对象的外周静脉血,通过血细胞分析仪对血小板相关参数进行测定,包括PDW、MPV及PLR。结果:观察组PLT和PLR高于对照组,MPV、PDW低于对照组,差异均有统计学意义(P<0.05)。观察组缓解时PLT、PDW、PLR低于化疗前,差异均有统计学意义(P<0.05),观察组缓解时与化疗前的MPV比较,差异无统计学意义(P>0.05)。观察组Ⅲ~Ⅳ期的患者PLR高于Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.05),与疾病缓解时比较,复发时MPV更低,PDW更高,差异均有统计学意义(P<0.05)。结论:对于DLBCL,PLT、PDW、MPV、PLR在疾病不同状态、分期具有重要的临床意义,是一组可行且简单的指标。

Changes in platelet parameters and secondary brain injury in acute craniocerebral trauma

Changes in platelet parameters are important in secondary brain injury in acute craniocerebral trauma We selected 163 patients with craniocerebral trauma who were admitted within 24 hours with nonoperative therapy. Platelet parameters of 40 healthy subjects served as controls. Platelet number was decreased, while mean platelet volume and platelet distribution width values were increased, at 1 and 3 days after injury. Platelet number was lower and mean platelet volume and platelet distribution width were larger in patients with traumatic cerebral infarction and those in Glasgow Coma Scale score 〈 8 group. Platelet number was negatively correlated to volume of cerebral edema, but positively correlated to Glasgow Outcome Scale score. These data indicate that changes in platelet parameters may be utilized to indicate the state of central nervous system injury and patient prognosis .

Tumor-infiltrating platelets predict postoperative recurrence and survival in resectable pancreatic neuroendocrine tumor

BACKGROUND Platelets have been reported to participate in tumor cell growth,extravasation,epithelial–mesenchymal transition,metastasis,and drug resistance.However,the importance of platelets in pancreatic neuroendocrine tumor(pNET)lacks adequate literature support.The predictive value of tumor-infiltrating platelets(TIPs)in pNET remains unclear.AIM To investigate the relationship between TIPs and the prognosis of patients with pNET following radical resection.METHODS In total,113 patients who had undergone radical surgical resection with a pathologic diagnosis of pNET were enrolled in this study.Immunohistochemical analysis of cluster of differentiation 42b(CD42b)expression in the tumor specimens was performed to determine the presence of TIPs.Univariate and multivariate analyses were used to analyze the prognostic value of TIPs.RESULTS TIPs were observed in intratumoral areas in 54 patients.Neither basic characteristics nor preoperative platelet-associated indicators showed a significant relationship with the presence of TIPs(all P>0.05).Patients with positive intratumoral CD42b expression had worse overall survival(P=0.005)and recurrence-free survival(P<0.001)than those with negative intratumoral CD42b expression.Multivariate analysis demonstrated that TIPs were independent prognostic factors for overall survival(P=0.049)and recurrencefree survival(P=0.003).Nevertheless,platelet count,mean platelet volume,and platelet-to-lymphocyte ratio were not associated with postoperative survival or recurrence in pNET patients(all P>0.05).CONCLUSION TIPs are a useful prognostic biomarker for patients with resectable pNET,and their detection represents a promising tool for pNET treatment strategy decisions.

Macrophage Inflammatory Protein-1 Beta (MIP-1<i>β</i>) and Platelet Indices as Predictors of Spontaneous Bacterial Peritonitis<br>—MIP, MPV and PDW in SBP

Background/Aims: The objective of this study is to measure macrophage inflammatory protein one beta (MIP-1β), mean platelet volume (MPV) and platelet distribution width (PDW) to evaluate their usefulness in the diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. Materials and Methods: This study comprised 41 cirrhotic patients with ascites. MPV, PDW and MIP-1β were measured in serum and ascitic fluid. Results: A significant increase MPV, PDW, C-reactive Protein (CRP) and white blood cell was observed in SBP group compared to non SBP (P ≤ 0.001, P = 0 β was significantly in-creased in ascitic fluid in patients with SBP versus non SBP (P ≤ 0.001). At cutoff value of 8.3 fl MPV had 85.7% sensitivity and 75% specificity (AUC = 0.876) for diagnosis of SBP. At cutoff value of 15.4 PDW had 90.4% sensitivity and 55% specificity (AUC = 0.762). At cutoff value of 121.9 pg/ml MIP-1β in ascitic fluid had 76.1% sensitivity and 100% specificity (AUC = 0.881) for detecting SBP. Conclusion: MIP-1β and platelet indices are useful marker in the diagnosis of SBP in cirrhotic patients. Combined measurement of MIP-1β in serum and ascitic fluid had 100% sensitivity and specificity for diagnosis of SBP.

Value of Pre- and Post-Treatment Platelet Indices in Patients with Immune Thrombocytopenic Purpura

Introduction: Immune thrombocytopenic purpura (ITP) is an acquired disorder characterized by isolated thrombocytopenia. There is no “gold standard” test that can establish the diagnosis of primary ITP. Therefore, the diagnosis is one of exclusion and is based on patient history, physical examination, complete blood count, and blood smear review. Platelet indices are biomarkers of platelet activation, allowing extensive investigations focusing on the diagnostic and prognostic values in various diseases without extra-costs. Mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) were investigated aiming at evaluating the correlation between pre- and post-treatment values in ITP patients. The sensitivity and specificity of platelet indices for assessment of their predictive value for treatment response were also evaluated. Methods: Fifty newly diagnosed primary ITP patients were selected from the Hematology Clinics of Ain Shams University Hospitals and classified into pediatric and adult groups. Platelet count, MPV, PDW, PCT have been recorded for all pre and post-treatment CBC samples using Beckman Coulter LH750 analyzer. Results: In pediatrics post-treatment MPV and PDW were significantly decreased while PCT was increased when compared to their values at the time of presentation (P < 0.01). The same results were obtained in adult patients, except for PDW which did not attain any significance. A significant correlation was found between pre-treatment values of these platelet indices and treatment response in pediatrics, while no significance was found between pre-treatment PDW and treatment response in adults. Conclusion: Increased pre-treatment MPV and PDW, and decreased PCT can provide diagnostic and predictive value for treatment response in ITP patients.

Changes in Platelet Indices during Pregnancy as Potential Markers for Prediction of Preeclampsia Development

Objective: To assess whether changes in platelet indices, detectable by simple complete blood count (CBC), during pregnancy could be used as markers for prediction of development of preeclampsia (PE). Methods: A total of 2813 pregnant women who received regular antenatal care until delivery were included. Participants were divided into 3 groups: normotensive pregnant women (n = 2621), women with PE without severe features (n = 169), and women with PE with severe features (n = 23). Blood samples were collected during antenatal visits and/or during the period of in-patient hospital stay, and changes in platelet indices were compared among the three groups. Results: Platelet count (PC) was decreasing while mean platelet volume (MPV) and platelet distribution width (PDW) were increasing as PE progressed. Receiver operating characteristics (ROC) curve analysis showed that PDW had the largest area under curve (AUC) [0.980 (95% CI: 0.964 - 1.000)], making it the best marker for predicting development of PE. Also, PDW showed the most statistically significant correlation with mean arterial pressure (MAP) (r = 0.902, p = 0.000), making it the best marker for predicting severity of hypertension. Conclusion: This study provides evidence that PC decreases while MPV and PDW increase as pregnancy advances, and these changes are more pronounced in PE than normotensive pregnancy. These changes predate development of PE by 2 - 8 weeks and are proportional to the progress of this disorder. The selected platelet indices, especially PDW, have the potential to be utilized as markers for not only prediction of PE development but also severity of hypertension.

凝血功能联合平均血小板体积与血小板计数比值对脑梗死的诊断价值

目的探讨凝血功能指标联合平均血小板体积与血小板计数比值对急性脑梗死(ACI)的诊断价值。方法95例ACI患者按照疾病严重程度分为轻度39例、中度37例及重度19例,比较不同程度ACI患者入院时的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D二聚体(D-Dimer)、纤维蛋白溶解产物(FDP)]和平均血小板体积与血小板计数比值;采用ROC曲线下面积(AUC)评估凝血功能指标、平均血小板体积与血小板计数比值单项或联合检测对ACI严重程度的诊断价值;采用Pearson相关系数(r)分析各项检测指标与ACI的相关性。结果轻度组患者PT、APTT及TT长于中度组和重度组,FIB、D-Dimer、FDP及平均血小板体积与血小板计数比值低于中度组和重度组,差异有统计学意义(P<0.05);ROC曲线结果显示,凝血功能指标、平均血小板体积与血小板计数比值联合检测诊断ACI的AUC为0.943,高于其他单项检测的AUC;相关性分析显示,ACI患者PT、APTT、FIB、TT、D-Dimer、FDP及平均血小板体积与血小板计数比值均存在一定的相关性(P<0.05)。结论不同严重程度ACI患者的凝血功能指标及平均血小板体积与血小板计数比值存在明显差异,凝血功能指标及平均血小板体积与血小板计数比值对ACI诊断具有一定价值,联合检测诊断价值更高。

平均血小板体积对血液透析患者急性缺血性脑血管病事件的预测价值

目的探讨平均血小板体积(MPV)与血液透析患者急性缺血性脑血管病事件(AICE)的相关性,评估MPV对AICE的预测价值。方法收集2015-01至2021-12北京朝阳医院肾内科透析室维持性血液透析(MHD)患者为研究对象(n=232),根据是否发生AICE分为AICE组(n=77)与非AICE组(n=155),比较两组间MPV及临床特征等差异。单因素及多因素Cox回归分析AICE发生的独立危险因素,绘制受试者工作特征曲线(ROC)评估MPV对血液透析患者AICE发生风险的预测价值。结果与非AICE组比较,AICE组患者MPV[10.7(10.3,11.3)fl vs.10.3(9.7,10.8)fl,Z=3.8938,P<0.001]明显升高,年龄、吸烟、CAD病史、1周平均超滤脱水量、总胆固醇、低密度脂蛋白胆固醇、三酰甘油均高于非AICE组,白蛋白低于AICE组。多因素Cox回归显示,矫正后AIS病史、吸烟、超滤脱水量增加、白蛋白降低、MPV增高[HR1.601(1.219,2.102);P<0.001]是AICE发生的独立危险因素。MPV预测血液透析患者AICE的ROC曲线下面积为0.824,特异度为0.883,敏感度为0.716。结论MPV是维持性血液透析患者AICE发生的独立危险因素,对AICE发生风险具有良好的预测价值。

MPVLR与消化性溃疡并发上消化道出血的关系

目的探讨平均血小板体积/淋巴细胞比值(MPVLR)与消化性溃疡(PU)并发上消化道出血(UGIB)的关系及其意义。方法将2021年6月—2023年6月安阳市人民医院诊治的233例PU病人作为研究组,另取同期体检健康人群210例为对照组。受试者入院后24 h内检测平均血小板体积(MPV)、淋巴细胞计数(LYM),并计算MPVLR。根据PU病人随访期间是否并发UGIB分为UGIB组(72例)及非UGIB组(161例)。采用受试者工作特性(ROC)曲线评估MPVLR对PU并发UGIB的诊断价值,采用多因素Logistic回归分析影响PU并发UGIB的危险因素。结果研究组MPVLR明显高于对照组(t=70.287,P<0.05)。UGIB组MPVLR明显高于非UGIB组(t=26.566,P<0.05)。ROC曲线分析显示,MPVLR诊断PU病人并发UGIB的曲线下面积为0.741(95%CI=0.761~0.861)。多因素Logistic逐步回归分析显示,使用非甾体类抗炎药物(OR=2.423,95%CI=1.650~3.558)、幽门螺杆菌感染(OR=3.047,95%CI=1.802~5.151)以及MPVLR(OR=3.762,95%CI=2.001~7.072)均为影响PU并发UGIB的危险因素(P<0.05)。结论MPVLR在PU并发UGIB病人中异常升高,对UGIB发生具有较高的预测价值。

MPV、D-二聚体和CRP在类风湿关节炎患者疾病活动中的研究

目的探讨血小板平均体积(mean platelet volume,MPV)和D-二聚体与类风湿关节炎(rheumatoid arthritis,RA)疾病程度的关系。方法选取2021年1月至12月就诊于萍乡市人民医院的120例RA患者,检测并分析患者治疗前后MPV、D-二聚体和C-反应蛋白(C-reactive protein,CRP)水平。结果患者治疗前后的MPV、D-二聚体和CRP水平比较,差异有统计学意义(P<0.05)。MPV、D-二聚体和CRP联合检测与疾病进展符合率为99.17%,高于单一项目检测(MPV、D-二聚体、CRP单一检测符合率分别为90.83%、91.67%、91.67%)。结论RA患者活动期MPV降低,与活动程度呈负相关;D-二聚体和CRP水平升高,与活动程度呈正相关。三者联合检测可提高RA疾病进展的阳性诊断率。MPV和D-二聚体可作为RA病情评估的新的生物学标志物,临床可参考其值预测疾病的发展和活动度。

巴中市80例急性ST段抬高型心肌梗死患者发生心力衰竭的危险因素分析

目的 分析巴中市急性ST段抬高型心肌梗死(STEMI)患者发生心力衰竭(HF)的现状及其影响因素。方法 选取2021年1月1日—2023年4月30日巴中市中心医院80例STEMI患者,根据有无发生HF分组,探寻可能导致STEMI患者HF的危险因素。结果 入组患者中28例发生HF,发生率35.00%。有HF组血清降钙素原(PCT)、总胆红素(TBiL)、超敏C反应蛋白(hs-CRP)、血小板平均体积(MPV)、同型半胱氨酸(Hcy)表达均较无HF组高(t=13.176、10.485、32.544、10.113、4.254,P<0.05);组间其他资料比较无统计学差异(P>0.05);Logistic回归分析显示血清PCT、TBiL、hs-CRP、MPV、Hcy高表达是导致STEMI患者发生HF的危险因素(OR>1,P<0.05)。结论 STEMI患者发生HF与血清PCT、TBiL、hs-CRP、MPV、Hcy指标高表达相关。

急性冠状动脉综合征患者入院早期白细胞计数与平均血小板体积比值和血小板与淋巴细胞比值与冠状动脉狭窄程度及院内主要不良心血管事件的评估价值

目的 分析急性冠状动脉综合征(ACS)患者的白细胞计数与平均血小板体积比值(WMR)和血小板与淋巴细胞比值(PLR)与冠状动脉病变严重程度的相关性,并探究WMR、PLR对冠状动脉狭窄程度及院内主要不良心血管事件(MACE)的预测价值。方法 本研究为回顾性分析,收集了2020年12月至2022年11月在新疆医科大学第一附属医院急诊抢救室因胸痛、胸闷首次诊断为ACS并接受经皮冠状动脉介入(PCI)治疗的391例患者数据。根据临床分型,将患者分为不稳定型心绞痛(UA)组147例,非ST段抬高型心肌梗死(NSTEMI)组114例,及ST段抬高型心肌梗死(STEMI)组130例。进一步按照是否出现院内MACE分为MACE组106例和无MACE组285例。依据Gensini评分中位数将患者分为重度病变组(Gensini评分≥53分)196例和轻度病变组(Gensini评分<53分)195例。比较各组患者的基本资料及实验室检查指标,使用二元多因素logistic回归模型筛选冠状动脉狭窄程度及院内MACE的影响因素,分析WMR、PLR与冠状动脉狭窄程度的相关性,并通过ROC曲线分析WMR、PLR及其联合对冠状动脉狭窄程度及院内MACE的预测诊断价值。结果 WMR和PLR与ACS患者冠状动脉狭窄程度均呈正相关(r=0.336,P<0.001;r=0.374,P<0.001)。二元多因素logistic回归分析表明,WMR和PLR均为冠状动脉狭窄程度和院内MACE的独立危险因素。ROC曲线结果显示,WMR、PLR及两者联合预测院内MACE的AUC分别为0.748、0.722和0.792;预测冠状动脉狭窄程度的AUC分别为0.694、0.716和0.770。结论 ACS患者入院早期WMR和PLR与冠状动脉狭窄程度呈正相关,并且具有预测院内MACE及冠状动脉狭窄程度的临床价值,其联合使用在诊断效果上更为优越。

抗栓治疗后血小板参数对非心源性脑梗死预后的预测价值研究

目的研究抗栓治疗后血小板参数对非心源性脑梗死(NCCI)预后的预测价值。方法71例NCCI患者,所有患者均于入院首日抗栓之前完成血小板参数[血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板计数(PLT)、PDW/PLT、MPV/PLT]测定。抗栓7 d后,所有NCCI患者均完善PDW、MPV、PLT、PDW/PLT、MPV/PLT复查,分别以PLT7、PDW7、MPV7、MPV7/PLT7、PDW7/PLT7表示。选取改良Rankin量表(MRS)对患者6个月时神经功能恢复情况做出评估,根据预后评估结果分为预后不良组(MRS评分>2分,10例)与预后良好组(MRS评分≤2分,61例)。①比较两组一般资料及血化验结果;②采用多因素Logistic回归分析NCCI患者抗栓7 d后预后不良的危险因素;③采用受试者工作特征曲线(ROC曲线)分析阳性指标对NCCI患者预后的预测价值。结果抗栓后,61例患者预后良好,10例患者预后不良。两组患者年龄、性别、饮酒、吸烟、冠心病、糖尿病、高血压、白细胞计数、尿酸、尿素氮、肌酐、同型半胱氨酸、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、总胆固醇、MPV、PDW、PLT7、PDW/PLT水平比较差异无显著性(P>0.05)。预后不良组患者PLT(157.72±46.53)×10^(9)/L明显低于预后良好组的(195.04±55.42)×10^(9)/L,MPV/PLT(0.77±0.14)×10^(-10)fl/L明显高于预后良好组的(0.61±0.23)×10^(-10)fl/L,差异有显著性(P<0.05);预后不良组患者MPV7、MPV7/PLT7、PDW7、PDW7/PLT7分别为(14.72±4.07)fl、(0.73±0.23)×10^(-10)fl/L、(11.63±1.48)fl、(0.92±0.39)×10^(-10)fl/L,明显高于预后良好组的(12.29±3.26)fl、(0.52±0.21)×10^(-10)fl/L、(9.81±1.58)fl、(0.71±0.25)×10^(-10)fl/L,差异有显著性(P<0.05)。将单因素分析中显示差异有显著性的因素(PLT、MPV/PLT、PDW7、PDW7/PLT7、MPV7、MPV7/PLT7)纳入多因素Logistic回归分析,结果显示:MPV7为NCCI患者预后不良的危险因素[OR=7.668,95%CI=(1.526,38.527),P=0.012<0.05]。ROC曲线显示:MPV7对NCCI患者的预后具有预测价值,以10.13 fl为临界值,MPV7预测NCCI患者预后不良的曲线下面积(AUC)为0.786[95%CI=(0.677,0.896),P=0.001<0.05],灵敏度为83.33%,特异度为69.50%。结论抗栓7 d后MPV为NCCI患者预后不良的危险因素,可辅助预测NCCI预后情况。

血清肿瘤异常蛋白、平均血小板体积/淋巴细胞比值与腹腔镜肝癌切除术患者预后的关系

目的 探究血清肿瘤异常蛋白(TAP)、平均血小板体积/淋巴细胞比值(MPVLR)与腹腔镜肝癌切除术患者预后的关系。方法 选取2020年1月至2022年9月河南科技大学第一附属医院诊治的肝癌患者85例,均接受腹腔镜肝癌切除术治疗。术前检测患者TAP、MPVLR水平。术后随访1年,观察患者术后肿瘤复发、转移以及死亡发生情况,并将其分为预后不良组和预后良好组。单因素和多因素logistic回归分析腹腔镜肝癌切除术患者预后的影响因素,应用受试者工作特征曲线下面积(AUC)评估血清TAP、MPVLR对患者预后的评估效能。结果 腹腔镜肝癌切除术患者预后不良发生率为27.06%(23/85)。预后不良组肿瘤直径≥3 cm占比、CNLC分期为Ⅲa期占比、肿瘤数量多发占比、TAP、MPVLR水平分别为73.9%、60.9%、65.2%、(187.8±37.5)μm^(2)、(7.7±1.93),均高于预后良好组的37.1%、27.4%、32.3%、(139.2±27.8)μm^(2)、(4.1±1.1),差异均有统计学意义(P<0.05)。多因素分析结果显示,CNLC分期(OR=6.62)、TAP(OR=5.39)、MPVLR(OR=3.85)是患者预后的独立危险因素(P<0.05)。ROC曲线显示,TAP、MPVLR及二者联合评估腹腔镜肝癌切除术患者预后的敏感度分别为0.78、0.74、0.87,特异度分别为0.76、0.74、0.92,AUC分别为0.82、0.80、0.91。结论 血清TAP、MPVLR是腹腔镜肝癌切除术患者预后不良的独立危险因素,TAP联合MPVLR评估患者预后的效能较好。