血小板平均容积与血小板计数比值与急性主动脉夹层住院病死率关系研究  

Relationship of mean platelet volume and platelet count ratio with in-hospital mortality in acute aortic dissection patients

作　　者：郭倩玉[1] 卢成志[1] Guo Qianyu;Lu Chengzhi(Department of Cardiology,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院心内科,300192

出　　处：《中华老年心脑血管病杂志》2018年第11期1161-1163,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨血小板平均容积(MPV)与血小板计数(PLT)与老年急性主动脉夹层患者住院病死率的关系。方法选择2010年1月1日~2016年1月1日天津市第一中心医院心脏科住院的主动脉夹层患者101例,根据住院期间是否存活分为存活组75例和死亡组26例;又根据MPV/PLT比值分为1分位组25例(MPV/PLT≤0.046),2分位组25例(0.046<MPV/PLT≤0.056),3分位组26例(0.056<MPV/PLT≤0.069),4分位组25例(MPV/PLT>0.069)。采集患者住院时基线资料及D-二聚体等,观察患者住院并发症及病死率。结果死亡组A型夹层、D-二聚体和MPV/PLT比值明显高于存活组[88.5%vs 38.7%,P=0.000;6374μg/L vs 2049μg/L,P=0.000;0.069±0.024 vs 0.056±0.018,P=0.003],收缩压和PLT明显低于存活组[(127.9±34.2)mm Hg(1mm Hg=0.133kPa)vs(158.2±32.1)mm Hg,P=0.000;(175.5±64.2)×109/L vs(205.4±61.9)×109/L,P=0.039]。不同分位组住院病死率比较,差异有统计学意义(P=0.033),4分位组住院病死率明显高于1、2和3分位组(48.0%vs 16.0%,20.0%,19.2%,P<0.05)。结论老年急性主动脉夹层患者MPV/PLT比值升高预示更高的病死率。Objective To study the relationship of mean platelet volume(MPV)and platelet count ratio(PLT)with in-hospital mortality in elderly acute aortic dissection(AAD)patients.Methods One hundred and one AAD patients admitted to our hospital were divided into survival group(n=75)and death group(n=26)and further divided into MPV/PLT≤0.046(Q1)group(n=25),0.046<MPV/PLT≤0.056(Q2)group(n=25),0.056<MPV/PLT≤0.069(Q3)group(n=26),and MPV/PLT>0.069(Q4)group(n=25)according to the MPV/PLT ratio.Their baseline data were recorded and serum D-dimer level was measured on admission,complications and mortality after admission were recorded.Results The incidence of A-type dissection,serum D-dimer level and MPV/PLT ratio were significantly higher in death group than in survival group(88.5%vs38.7%,P=0.000;6374μg/L vs 2049μg/L,P=0.000;0.069±0.024 vs0.056±0.018,P=0.003).The SBP and platelet count were significantly lower in death group than in survival group(127.9±34.2 mm Hg vs 158.2±32.1 mm Hg,P=0.000;175.5±64.2×109/L vs 205.4±61.9×109/L,P=0.039).The in-hospital mortality was significantly different in different MPV/PLT ratio groups(P=0.033)and was significantly higher in Q4 group than in Q1,Q2 and Q3 groups(48.0%vs 16.0%,20.0%,19.2%,P<0.05).Conclusion Elevated MPV/PLT ratio indicates a higher in-hospital mortality in elderly AAD patients.

关 键 词：血小板 血小板计数 动脉瘤 夹层 血小板活化 胸痛 肿瘤坏死因子A 白细胞介素6 

分 类 号：R543.1[医药卫生—心血管疾病]