血小板相关参数在急性胰腺炎病情严重程度预测中的相关性研究  

Correlation of platelet related parameters in predicting severity of acute pancreatitis

作　　者：金磊 周淑萍 曹子君 杨亚东[3] JIN Lei;ZHOU Shuping;CAO Zijun;YANG Yadong(Department of Intensive Care Medicine,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan,Anhui,232000,China;Department of Gastroenterology,The First Affiliated Hospital of Anhui University of Science and Technology;Department of Intensive Care Medicine,Huanggang Central Hospital)

机构地区：[1]安徽理工大学第一附属医院重症医学科,安徽淮南232000 [2]安徽理工大学第一附属医院消化内科 [3]黄冈市中心医院重症医学科

出　　处：《临床急诊杂志》2021年第2期111-116,共6页Journal of Clinical Emergency

基　　金：安徽高校自然科学研究项目(No:KJ2019A0093)。

摘　　要：目的:探讨平均血小板体积(MPV)、血小板分布宽度(PDW)、平均血小板体积与血小板计数绝对值比率(MPV/PLT)和急性胰腺炎(AP)患者病情严重程度的相关性。方法:选取符合《中国急性胰腺炎诊治指南(2019年,沈阳)》诊断标准的90例急性胰腺炎患者作为研究对象(研究组),以同期82例健康体检者作为对照(对照组)。将研究组按照病情严重程度分为轻症组(MAP)、中度重症组(MSAP)、重症组(SAP)。记录患者基本信息及急性胰腺炎严重程度床边指数(BISAP评分),于确诊72 h内取静脉血检测,包括:WBC、RDW、PLT、PDW、MPV、CRP、TBiL、D-Dimer、MPV/PLT、PDW/PLT、血肌酐等。用Logistic回归分析疾病的危险因素。采用Spearman分析进行相关性研究。绘制受试者操作特征(ROC)曲线,评估血小板参数对疾病严重程度预测价值。结果:研究组中MAP 36例、MSAP 29例、SAP 25例。研究组血糖(mmol/L)(10.28±1.02)、PDW(fL)(19.38±3.27)、MPV(fL)(10.80±2.01)、PDW/PLT(0.13±0.03)、MPV/PLT(0.09±0.03)均高于对照组。研究组PLT低于对照组[(150.21±54.78)×10^(9)/L vs.(190.12±68.53)×10^(9)/L]。研究组中,轻症组的BISAP评分(1.42±0.08)、血糖(6.02±0.97)、PDW(16.76±1.55)、MPV(8.49±1.31)、PDW/PLT(0.09±0.12)、MPV/PLT(0.06±0.01)<中度重症组的BISAP评分(2.35±1.04)、血糖(10.12±1.18)、PDW(20.20±0.95)、MPV(11.01±0.66)、PDW/PLT(0.13±0.01)、MPV/PLT(0.11±0.01)<重症组的BISAP评分(3.13±1.21)、血糖(12.49±1.53)、PDW(23.48±1.25)、MPV(13.52±1.10)、PDW/PLT(0.16±0.02)、MPV/PLT(0.13±0.01);PLT:轻症组(218.44±28.43)×10^(9)/L>中度重症组(163.28±17.20)×10^(9)/L>重症组(101.28±25.18)×10^(9)/L。Logistic回归分析显示,PDW、MPV、MPV/PLT、BISAP评分是急性胰腺炎病情程度的独立危险因素[PDW(OR=3.218,95%CI:2.381~5.193)、MPV(OR=2.341,95%CI:1.010~5.422)、MPV/PLT(OR=1.764,95%CI:0.768~4.052)、BISAP评分(OR=3.104,95%CI:1.261~6.397),均P<0.05]。Spearman相关性分析显示MPV(r=0.781)�Objective: To explore the correlation between mean platelet volume(MPV), platelet distribution width(PDW), mean platelet volume to absolute platelet count ratio(MPV/PLT) for the severity of acute pancreatitis. Methods: Ninety patients with acute pancreatitis who met the diagnostic criteria of the Guidelines for the Diagnosis and Treatment of Acute Pancreatitis in China(2019, Shenyang) were selected as the research subjects, and healthy physical controls during the same period were taken as controls. The researched group was divided into MAP group, MSAP group, and SAP group according to the severity of the disease. Patient’s basic information and bedside index of acute pancreatitis severity(BISAP score) were recorded, and venous blood tests within 72 hours of diagnosis were taked, including WBC, RDW, PLT, PDW, MPV, CRP, TBiL, D-Dimer, MPV/PLT, PDW/PLT, serum creatinine, etc. Logistic regression was used to analyze the risk factors of the disease, Spearman analysis was used for correlation study. The receiver operating characteristic curve(ROC) was applied to evaluate the predictive value of platelet parameters to the severity of the disease. Results: Ninety patients with acute pancreatitis and eighty-two healthy controls were enrolled. There were 36 mild cases, 29 moderately severe cases and 25 severe cases of acute pancreatitis patients. Blood glucose(10.28±1.02) mmol/L, PDW(19.38±3.27) fL, MPV(10.80±2.01) fL, PDW/PLT(0.13±0.03), MPV/PLT(0.09±0.03) of the study group were higher than those in the healthy control group. The PLT(150.21±54.78) ×10^(9)/L of the studied group was lower than that in the healthy control group(190.12±68.53) ×10^(9)/L. In the study group, the BISAP scores(1.42±0.08), blood glucose(6.02±0.97), PDW(16.76±1.55), MPV(8.49±1.31), PDW/PLT(0.09±0.12), MPV/PLT(0.06±0.01) of the MAP group the MSAP group(163.28±17.20)>the SAP group(101.28±25.18). The logistic regression analysis showed that PDW(OR=3.218, 95%CI: 2.381-5.193), MPV(OR=2.341, 95%CI: 1.010-5.422), MPV/PLT(OR=1.764, 95

关 键 词：急性胰腺炎 平均血小板体积 血小板分布宽度 平均血小板体积与血小板计数绝对值比率 

分 类 号：R657.5[医药卫生—外科学]