红细胞分布宽度和血小板计数的比值对颅内静脉窦血栓形成患者预后的预测价值  

Predictivethe Value of Red Blood Cell Distribution Width to Platelet Ratio in Patients with Intracranial Venous Sinus Thrombosis

作　　者：余广兰[1] 魏俊[1] Yu Guanglan;Wei Jun(Department of Neurology,First People′s Hospital,Yibin City,Sichuan Province,Yibin,Sichuan 644000,China)

机构地区：[1]宜宾市第一人民医院神经内科,四川宜宾644000

出　　处：《四川医学》2020年第3期276-280,共5页Sichuan Medical Journal

摘　　要：目的探讨细胞分布宽度和血小板计数的比值(RPR)在颅内静脉窦血栓形成(Cerebral Venous Sinus Thrombosis,CVST)诊断及预后判断中的价值。方法回顾性分析我院156例CVST患者的临床资料,根据改良Rankin量表(mRS)评分结果分为预后良好组(n=116例)和预后不良组(n=40例)。比较两组人口统计学、病因、临床特征及实验室指标等相关因素;采用多因素logistic回归分析CVST患者转归不良的独立预测因素;绘制40例预后不良患者的受试者工作特征(ROC)曲线,探讨RPR值对CVST患者预后的评估作用;按最佳阈值分为高RPR组和低RPR组,采用Kaplan-Meier法分析两组的生存率。结果156例CVST患者中116例(74.36%)预后良好,40例(25.64%)预后不良,22例(14.10%)死亡;两组年龄、昏迷、主要侧支循环、RDW、D-D、PLT、RPR比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示:主要侧支循环、RDW、D-D、RPR均是预测CVST患者预后的独立危险因素(P<0.05);RPR值预测CVST患者预后的ROC曲线下面积为0.896,最佳阈值为0.072,灵敏度95.00%,特异度79.30%;Kaplan-Meier法生存分析曲线提示:高RPR组生存率低于低RPR组,差异有统计学意义(P<0.05)。结论RPR值可较好地预测CVST患者预后,RPR大于0.072增加患者预后不良风险。Objective To investigate the value of red blood cell distribution width to platelet ratio(RPR)in the diagnosis and prognosis of cerebral venous sinus thrombosis(CVST).Methods The clinical data of 156 CVST patients in our hospital were retrospectively analyzed,and they were divided into good prognosis group(n=116 cases)and poor prognosis group(n=40 cases)according to the modified Rankin Scale(mRS)score.Compare the demographics,etiology,clinical characteristics,and laboratory indicators of the two groups.Multivariate logistic regression analysis of independent predictors of poor outcomes in patients with CVST.Draw the receiver operating characteristic(ROC)curve of 40 patients with poor prognosis,and explore the role of RPR value in assessing the prognosis of CVST patients.According to the optimal threshold,it was divided into high RPR group and low RPR group,and Kaplan-Meier method was used to analyze the survival rate of the two groups.Results In the 156 CVST patients,116(74.36%)had a good prognosis,40(25.64%)had a poor prognosis,and 22(14.10%)died.There were significant differences in age,coma,major collateral circulation,RDW,D-D,PLT,and RPR between the two groups(P<0.05).Multivariate Logistic regression analysis showed that the main collateral circulation,RDW,D-D,and RPR were independent risk factors for predicting the prognosis of patients with CVST(P<0.05).The RPR value predicts the area under the ROC curve of CVST patients is 0.896,the optimal threshold is 0.072,the sensitivity is 95.00%,and the specificity is 79.30%.Kaplan-Meier survival analysis curve suggested that the survival rate of the high RPR group was lower than that of the low RPR group(P<0.05).Conclusion RPR value can better predict the prognosis of patients with CVST.RPR greater than 0.072 increases the risk of poor prognosis.

关 键 词：颅内静脉窦血栓 红细胞分布宽度 血小板计数 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]