血小板参数、PDW/PLT和MPV/PLT变化对社区获得性肺炎患者预后评估价值  

The Clinical Value of the Change in Platelet Parameters,PDW/PLT and MPV/PLT in Assessing the Prognosis of Community Acquired Pneumonia

作　　者：刘乔乔 许能銮[1] 陈海燕[1] 吴婧[1] LIU Qiaoqiao;XU Nengluan;CHEN Haiyan;WU Jing(Provincial Clinical Medical College of Fujian Medical University,Department of Respiratory and Critical Care Medicine,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院呼吸与危重症医学科,福州350001

出　　处：《福建医科大学学报》2020年第3期156-160,共5页Journal of Fujian Medical University

摘　　要：目的观察血小板参数、血小板分布宽度/血小板计数(PDW/PLT)和平均血小板体积/血小板计数(MPV/PLT)在社区获得性肺炎患者中的变化,并探讨其对预后的评估价值。方法回顾性分析2017年4月-2019年6月接受住院治疗的240例社区获得性肺炎患者的临床资料,按预后分为生存组和死亡组,比较两组患者的基本资料、实验室指标[入院时初次血小板参数(PLT1,MPV 1及PDW1)、出院前或者临终前最后一次的血小板参数(PLT2,MPV2及PDW2)];根据患者病情分为重症肺炎组和非重症肺炎组,比较两组患者的血小板参数;绘制PDW/PLT比值和MPV/PLT比值的受试者工作特征(ROC)曲线,比较ROC曲线下面积,根据ROC曲线得到PDW2/PLT2和MPV2/PLT2对应的Cut-off值,比较不同水平PDW/PLT和MPV/PLT比值患者的炎症指标和死亡率的区别。结果(1)死亡组的PLT呈下降趋势,但MPV及PDW呈上升趋势;(2)重症肺炎组的PLT1及PLT2小于非重症组,MPV2,PDW1及PDW2均大于非重症组;(3)高MPV/PLT比值组、高PDW/PLT比值组患者的降钙素原、死亡率、CRUB-65评分均显著高于低比值组。结论(1)临床上动态监测血小板参数,PLT呈下降趋势,PDW和MPV呈上升趋势,提示肺炎患者死亡风险增加;(2)PDW/PLT和MPV/PLT比值增大与肺炎患者死亡风险增加存在相关性。Objective To observe the changes in platelet parameters,PDW/PLT ratio and MPV/PLT ratio in patients with community-acquired pneumonia,and to study its predictive effect on prognosis.Methods A retrospective study was conducted.Clinical data from 240 patients with community acquired pneumonia admitted to the Provincial Clinical Medical College of Fujian Medical University from April,2017 to June,2019 were collected.The patients were divided into two groups according to prognosis.General information and laboratory indexes include:serum platelet parameters levels at first time(PLT1,MPV1,PDW1)and last time(PLT2,MPV2,PDW2)after admission were compared.According to the severity of the disease,all the patients were divided into the severe group and the non-severe group,and the differences of platelet parameters were compared.Receiver operating characteristic curve(ROC curve)was drawn for PDW/PLT ratio and MPV/PLT ratio,and the area under curve(AUC)was compared.According to the ROC curve,the Cut-off value corresponding to PDW2/PLT2 and MPV2/PLT2 were obtained,while the patients were divided into two groups.The inflammatory index and mortality between different levels of PDW/PLT ratio and MPV/PLT ratio were compared.Results(1)In the death group,PLT showed a downward trend,but MPV and PDW showed an upward trend.(2)In the severe group,the PLT1 and PLT2 were smaller,but MPV2,PDW1 and PDW2 were larger than those in the non-severe pneumonia group.(3)The procalcitonin,the mortality,and CRUB-65 scores of patients with high MPV/PLT ratio and high PDW/PLT ratio were significantly higher than those in the low ratio group.Conclusions(1)In monitoring of platelet parameters,PLT shows a downward trend,while PDW and MPV show an upward trend,indicating an increased risk of death in patients with pneumonia.(2)The increased PDW/PLT ratio and MPV/PLT ratio are correlated with the increased risk of death in patients with pneumonia.

关 键 词：血小板计数 血小板 肺炎 预后 

分 类 号：R331.124[医药卫生—人体生理学] R563.1[医药卫生—基础医学]