摘要
目的探讨平均血小板体积与血小板计数比值(MPV/PLT)在社区获得性肺炎(CAP)预后中的预测价值。方法选取2018年1月至2020年7月于郑州大学第二附属医院住院治疗的符合标准的CAP患者223例。按照入院28 d内的预后情况分为存活组与死亡组,其中存活组169例,死亡组54例。比较两组临床资料,分析MPV/PLT与降钙素原(PCT)、C-反应蛋白(CRP)的相关性,应用logistic回归分析影响CAP预后的独立危险因素。绘制受试者工作特征(ROC)曲线评估MPV/PLT对预后的预测价值,根据最佳界值绘制Kaplan-Meier生存分析曲线。结果两组年龄、性别比例与白细胞计数比较,差异无统计学意义(P>0.05);存活组中性粒细胞百分数、PCT、CRP、MPV与MPV/PLT低于死亡组,PLT高于死亡组(P<0.05)。CAP患者MPV/PLT与PCT、CRP呈正相关(r=0.483、0.489,P<0.05)。logistic回归分析显示MPV/PLT是影响患者预后的独立危险因素。MPV/PLT预测CAP早期转归的曲线下面积为0.773,敏感度为85.2%,特异度为62.1%,最佳界值为0.0645,95%CI:0.703~0.842(P<0.05)。MPV/PLT≥0.0645组共110例患者,MPV/PLT<0.0645组共113例患者。MPV/PLT≥0.0645组PCT、CRP及病死率均高于MPV/PLT<0.0645组(P<0.05)。MPV/PLT≥0.0645组累积生存率低于MPV/PLT<0.0645组(Log-rank=37.974,P<0.05)。结论MPV/PLT可能是影响CAP预后的独立危险因素,在预测患者预后方面具有良好的临床价值。
Objective To explore the predictive value of the ratio of mean platelet volume to platelet count(MPV/PLT)in the prognosis of community acquired pneumonia(CAP).Methods A total of 223 CAP patients who were hospitalized in the Second Affiliated Hospital of Zhengzhou University from January 2018 to July 2020 were selected.According to the prognosis of hospitalized 28 days patients were divided into survival group and death group,including 169 cases in the survival group and 54 cases in the death group.The clinical data of the two groups were compared,the correlation between MPV/PLT and procalcihonin(PCT)and C-reactive protein(CRP)was analyzed,logistic regression was used to analyze independent risk factors that affect the prognosis of CAP.The receiver operating characteristic curve(ROC)was drawn to evaluate the prognostic value of MPV/PLT,the Kaplan-Meier survival analysis curve was drawn according to the best cut-off value.Results There were no significant differences in age,sex and white blood cell count between the two groups(P>0.05);compared with the death group,the percentage of neutrophils,PCT,CRP,MPV and MPV/PLT were lower,and PLT was higher(P<0.05).There was a positive correlation between MPV/PLT and PCT and CRP(r=0.483,0.489,P<0.05).The logistic regression analysis showed that MPV/PLT was an independent risk factor affecting the prognosis of patients.The area under curve of MPV/PLT was 0.773,the sensitivity was 85.2%,the specificity was 62.1%,the best cut-off value was 0.0645,and the 95%CI:0.703-0.842(P<0.05).There were 110 patients in the MPV/PLT≥0.0645 group,and 113 patients in the other group.The PCT,CRP and mortality rates in the MPV/PLT≥0.0645 group were higher than the other group(P<0.05).The cumulative survival rate of MPV/PLT≥0.0645 group was lower than that of MPV/PLT<0.0645 group(Log-rank=37.974,P<0.05).Conclusion MPV/PLT may be an independent risk factor affecting the prognosis of CAP and has good clinical value in predicting the prognosis of patients.
作者
袁晓雨
张铁栓
YUAN Xiaoyu;ZHANG Tieshuan(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Zhengzhou University,Henan Province,Zhengzhou,450014,China)
出处
《中国医药导报》
CAS
2021年第28期108-112,共5页
China Medical Herald
基金
河南省社发领域科技攻关项目(162102310551)。
