摘要
目的 探讨血小板体积分布宽度(platelet distribution width,PDW)对Wells评分低中危患者发生肺栓塞的预测价值。方法 选择上海健康医学院附属崇明分院2020年1月至2022年1月收治的100例Wells评分为低中危的可疑肺栓塞患者,按照肺栓塞发生情况分为肺栓塞组和非肺栓塞组。比较两组患者的PDW、血小板计数(platelet count,PLT)、血小板平均容积(mean platelet volume,MPV)等血小板相关参数及年龄、性别、体重指数(body mass index,BMI)等临床资料。应用受试者工作特征曲线(receiver operating characteristic,ROC)曲线分析PDW预测Wells评分低中危患者发生肺栓塞的效能及曲线下面积(area under the curve,AUC)。结果 100例患者中42例(42.00%)明确肺栓塞的诊断。肺栓塞组与非肺栓塞组患者的年龄、BMI、性别、Wells评分比较差异无显著性(P>0.05);肺栓塞组患者的PDW、MPV及右心室内径、肺动脉收缩压高于非肺栓塞组,PLT低于非肺栓塞组,差异有显著性(P<0.05)。PDW单独预测Wells评分低中危患者发生肺栓塞的敏感度与特异度分别为83.33%、84.48%,AUC为0.875;PDW联合PLT、MPV预测患者发生肺栓塞的敏感度与特异度分别为92.86%、94.83%,AUC为0.948。结论 Wells评分低中危患者存在较高的肺栓塞风险,PDW单独及联合PLT、MPV均有助于预测该类患者是否会发生肺栓塞。
Objective To analyze the predictive value of platelet distribution width(PDW)for pulmonary embolism in patients with low and moderate Wells score.Method 100 patients with suspected pulmonary embolism who were admitted to Chongming Hospital affiliated to Shanghai University of Medicine and Health Sciences from January 2020 to January 2022 were divided into pulmonary embolism group and non-pulmonary embolism group according to the occurrence of pulmonary embolism.Platelet-related parameters such as PDW,platelet count(PLT),mean platelet volume(MPV)and clinical data such as age,sex and body mass index(BMI)were compared between the two groups.Receiver operating characteristic curve(ROC)was used to analyze the effectiveness of PDW in predicting pulmonary embolism in patients with low and moderate Wells score and the area under the curve(AUC).Result Of the 100 patients,42 cases(42.00%)were diagnosed with pulmonary embolism.There was no significant difference in age,BMI,sex and Wells score between pulmonary embolism group and non-pulmonary embolism group(P>0.05).PDW,MPV,right ventricular diameter and pulmonary systolic pressure in pulmonary embolism group were higher than those in non-pulmonary embolism group,while PLT was lower than that in non-pulmonary embolism group,with significant difference(P<0.05).The sensitivity and specificity of PDW alone in predicting pulmonary embolism in patients with low and moderate Wells score were 83.33%and 84.48%,respectively,and AUC was 0.875.The sensitivity and specificity of PDW combined with PLT and MPV in predicting pulmonary embolism were 92.86%and 94.83%respectively,and the AUC was 0.948.Conclusion Patients with low Wells score and moderate risk have higher risk of pulmonary embolism.PDW alone and in combination with PLT and MPV are helpful to predict whether pulmonary embolism occurs in such patients.
作者
钱悦
陈卫香
顾立华
赵增艳
韦彩雯
Qian Yue;Chen Weixiang;Gu Lihua;Zhao Zengyan;Wei Caiwen(Department of General Practice,Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences,Shanghai 202150,China)
出处
《中国医刊》
CAS
2023年第10期1071-1074,共4页
Chinese Journal of Medicine
基金
上海市科学技术委员会科研项目(11DZ1931500)。
