Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia

BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are compromised.Accurate diagnosis of pneumonia is imperative for timely and effective interventions.Saliva,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in infants.AIM To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and MPV.RESULTS The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy controls.MPV exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>8.8.Correlations between serum CRP,sCRP,and MPV were also identified.Notably,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic tool.CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among neonates.These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.

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.

Can mean platelet volume play a role in evaluating the severity of acute pancreatitis?

AIM To investigate serum mean platelet volume(MPV) levels in acute pancreatitis(AP) patients and assess whether MPV effectively predicts the disease severity of AP.METHODS We included 117 consecutive patients with AP as the AP group and 34 consecutive patients with colorectal polyps(before endoscopic treatment) as the control group. Complete blood counts, liver function, platelet indices(MPV), coagulation parameters, lactate dehydrogenase(LDH) and C-reactive protein(CRP) were measured on days 1, 2, 3 and 7 after admission. Receiver operating characteristic curves were used to compare the sensitivity and specificity of MPV, white blood cell(WBC), LDH and CRP in predicting AP severity. The Modified Glasgow Prognostic Score(m GPS) and the 2012 revised Atlanta criteria were used to evaluate disease severity in AP.RESULTS MPV levels were significantly lower in the AP group than in the control group on day 1(P = 0.000), day 2(P = 0.029) and day 3(P = 0.001) after admission.In addition, MPV values were lower on day 1 after admission than on day 2(P = 0.012), day 3(P = 0.000) and day 7(P = 0.002) in all AP patients. Based on the m GPS, 78 patients(66.7%) were diagnosed with mild and 39 patients(33.3%) with severe AP. There was no significant difference in mean MPV levels between patients diagnosed with mild and severe AP based on the m GPS(P = 0.424). According to the 2012 revised Atlanta criteria, there were 98 patients(83.8%) without persistent organ failure(OF) [non-severe acute pancreatitis(non-SAP) group] and 19 patients(16.2%) with persistent OF(SAP group). MPV levels were significantly lower in the SAP group than in the non-SAP group on day 1 after admission(P = 0.002). On day 1 after admission using a cut-off value of 6.65 f L, the overall accuracy of MPV for predicting SAP according to the 2012 revised Atlanta criteria(AUC = 0.716) had a sensitivity of 91.8% and a specificity of 47.4% and was superior to the accuracy of the traditional markers WBC(AUC = 0.700) and LDH(AUC = 0.697).CONCLUSION MPV can be used at no additional cost as a useful, noninvasive biomarker that distinguishes AP with persistent OF from AP without persistent OF on day 1 of hospital admission.

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.

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.

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 as a novel predictor of systematic inflammatory response in cirrhotic patients with culturenegative neutrocytic ascites

AIM: To identify a mean platelet volume(MPV) cutoff value which should be able to predict the presence of bacterial infection.METHODS: An observational, analytic, retrospective study. We evaluated medical records of cirrhotic patients who were hospitalized from January 2012 to January 2014 at the Gastroenterology Department of "Hospital General de México Dr. Eduardo Liceaga", we included 51 cirrhotic patients with ascites fluid infection(AFI), and 50 non-infected cirrhotic patients as control group. Receiver operator characteristic curves were used to identify the best cutoff value of several parameters from hematic cytometry, including MPV, to predict the presence of ascites fluid infection.RESULTS: Of the 51 cases with AFI, 48 patients(94.1%) had culture-negative neutrocytic ascites(CNNA), 2(3.9%) had bacterial ascites, and one(2%)had spontaneous bacterial peritonitis. Infected patients had greater count of leucocytes and polymorphonuclear cells, greater levels of MPV and cardiac frequency(P < 0.0001), and lower mean arterial pressure compared with non-infected patients(P = 0.009). Leucocytes, polymorphonuclear count, MPV and cardiac frequency resulted to be good or very good predictive variables of presence of AFI in cirrhotic patients(area under the receiving operating characteristic > 0.80). A cutoff MPV value of 8.3 fl was the best to discriminate between cirrhotic patients with AFI and those without infection. CONCLUSION: Our results support that MPV can be an useful predictor of systemic inflammatory response syndrome in cirrhotic patients with AFI, particularly CNNA.

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.

The Relationship Between Mean Platelet Volume and In-Hospital Mortality in Geriatric Patients with ST Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Objective:We planned to investigate the effect of mean platelet volume(MPV)on in-hospital mortality and coronary risk factors in geriatric patients with ST segment elevation myocardial infarction(STEMI)who underwent primary percutaneous coronary intervention(PCI).Methods:We enrolled 194 consecutive STEMI patients.The study population was divided into two groups on the basis of admission MPVs.The high-MPV group(n=49)included patients in the highest tertile(>8.9 fL),and the low-MPV group(n=145)included patients with a value in the lower two tertiles(≤8.9 fL).Clinical characteristics,in-hospital mortality,cardiovascular risk factors,and outcomes of primary PCI were analyzed.Results:The patients in the high-MPV group were older,more of them had three-vessel disease,and they had higher in-hospital mortality.Patients with in-hospital death were older,had higher Gensini score,creatinine concentration,and MPV,and had lower HDL cholesterol concentration.MPV,age,HDL cholesterol concentration,creatinine concentration,and Gensini score were found to be independent predictors of in-hospital death.Conclusion:These results suggest that high admission MPV levels are associated with increased in-hospital mortality in geriatric patients with STEMI undergoing primary PCI.

Value of mean platelet volume in evaluating the severity of acute pancreatitis

Objective:To investigate the changes of mean platelet volume (MPV) in the course of acute pancreatitis (AP) and its value in evaluating the severity of AP.Methods: Retrospectively reviewed the clinical data of 214 patients with acute pancreatitis. According to the severity of the disease, the patients were divided into 64 patients with severe acute pancreatitis, 150 patients with non-severe acute pancreatitis. 63 healthy subjects were used as a control group. Compared the MPV levels between AP group and healthy control group. Compare the levels of MPV, CRP, LDH, Ca2+ and WBC between severe AP group and non-severe AP group. Compared the levels of MPV in acute phase and remission of acute pancreatitis. The receiver operating characteristic (ROC) curve was used to evaluate the value of MPV, CRP, LDH, Ca2+ and WBC in predicting severe acute pancreatitis.Results: Compared with the healthy control group, the MPV levels in the AP group were lower. In the acute phase and the remission period, the MPV levels in the severe AP group were lower than that in the non-severe group. The area under the ROC curve (AUC) of MPV, CRP, LDH, Ca2+ and WBC in predicting severe acute pancreatitis were 0.791, 0.655, 0.708, 0.707, 0.622.Conclusion:AP patients have lower MPV and MPV levels in remission period are higher than that in acute phase. In both acute phase and remission, MPV levels in severe AP group are lower than non-severe AP group. Compared with CRP, LDH, Ca2+ and WBC, MPV has obvious advantage in predicting severe AP.

Usefulness of white blood cell count to mean platelet volume ratio for predicting long-term prognosis after primary percutaneous coronary intervention in patients with acute coronary syndrome

Background and Objective The white blood cell count to mean platelet volume ratio(WMR)has recently been described as a predictor of cardiovascular events in patients who undergo percutaneous coronary intervention(PCI).The aim of this study was to investigate the usefulness of admission WMR in predicting outcomes in patients with acute coronary syndrome(ACS).

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.

Combined Detection of Mean Platelet Volume and Immunoglobins as a Strategy for the Diagnosis of Systemic Lupus Erythematosus

Objective:To explore the possibility of diagnosing and monitoring patients with systemic lupus erythematosus(SLE)using the combination of mean platelet volume(MPV)and routine immunoglobulin test.Methods:116 patients with SLE were divided into 3 groups according to their clinical characteristics,including 29 patients with renal impairment,44 cases of active stage and 43 cases of inactive patients.40 healthy subjects were randomly selected as controls.Subjects were tested for routine blood test and plasma Immunoglobins,such as IgG,IgA,IgM,C3,C4,CH50,CRP.The results were analyzed and the characteristics of each group of subjects were determined,the correlation between test results and diagnosis were studied.Results:In comparison to the control group,the serum level of MPV,C3 and C4 were decreased(P<0.05),and C reactive protein level was elevated(P<0.001)in the three groups of SLE patients.The IgG level in active and inactive SLE patients was increased(P<0.0001),CH50 level was decreased in patients with inactive SLE(P<0.05),IgA level of active SLE subjects was found to be elevated(P<0.05),IgM in patients with renal impairment was decreased(P<0.05).Other than that,no other significant characteristic were found.Conclusion:The pathogenesis of SLE is a complex process involving multiple factors.The changes of MPV,IgG,IgA,IgM,C3,C4,CH50 and CRP in SLE patients are characteristic parameters.The combination of the above indicators can help to determine the diagnosis and staging of SLE.The timely diagnosis and treatment of SLE patients has important clinical significance in protecting the organ function of SLE patients and improving the prognosis.

Are mean platelet volume and splenomegaly subclinical inflammatory marker in children with familial mediterranean fever?

The present study aimed to investigate the correlation of MPV and splenomegaly as inflammation activity of FMF patients at the attacks free period. We retrospectively reviewed the medical records of 43 patients with FMF. This study was performed at the attack free period as clinical and laboratory. For this study, patients were divided into two groups. Patients with splenomegaly is called group 1 (n = 12) and patients with no splenomegaly is called group 2 (n = 31). Groups were compared respect to age, gender, platelet counts, acute phase reactants and MPV. The mean MPV (fl) were significantly higher in group 1 (8.9 &#177;0.8) than in group 2 (8.4 &#177;0.5, p 【0.05). This study suggested that increased MPV and splenomegaly without amyloidosis could be a sign of chronic inflammation in children with FMF even in attack free period.

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。

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。

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。

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。