平均血小板体积和中性粒细胞百分比的变异系数预测脓毒症患者治疗30 d全因死亡的价值  

Value of variable coefficient of mean platelet volume and neutrophil percentage in predicting 30 d all-cause death of patients with sepsis

作　　者：李丹 石岩[1] 杨海晨[1] 付婧[1] 葛文汉[1] LI Dan;SHI Yan;YANG Haichen;FU Jing;GE Wenhan(Department of Emergency and Critical Care Medicine,Huai′an Municipal Second People′s Hospital,Huai′an,Jiangsu 223002,China)

机构地区：[1]江苏省淮安市第二人民医院急诊与重症医学科,江苏淮安223002

出　　处：《国际检验医学杂志》2022年第24期2958-2962,共5页International Journal of Laboratory Medicine

基　　金：江苏省“六大人才高峰”高层次人才选拔培养资助(WSN-041)。

摘　　要：目的分析平均血小板体积(MPV)和中性粒细胞百分比(NEU%)的变异系数预测脓毒症患者治疗30 d全因死亡的应用价值。方法回顾性选取2018年1月至2020年3月该院收治的确诊脓毒症患者共112例,根据治疗30 d生存结局分为存活组和死亡组;首先采用单因素比较两组患者临床资料和生化指标,然后采用多因素Logistic回归分析筛选患者治疗30 d全因死亡的危险因素,最后采用受试者工作特征(ROC)曲线分析MPV-CV和NEU%-CV预测患者治疗30 d全因死亡的效能。结果存活组80例,死亡组32例。与存活组相比,死亡组患者入院急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分和序贯器官衰竭(SOFA)评分升高,机械通气率增加,MPV-CV和NEU%-CV升高,差异均有统计学意义(P<0.05)。Logistic回归分析显示,APACHEⅡ评分≥18分、SOFA评分≥8分、MPV-CV≥25%、NEU%-CV≥38%和机械通气是脓毒症患者治疗30 d全因死亡的独立危险因素(P<0.05)。ROC曲线分析显示,MPV-CV%和NEU%-CV预测脓毒症患者治疗30 d全因死亡的AUC分别为0.821和0.839(P<0.05)。结论MPV-CV和NEU%-CV升高与脓毒症患者治疗30 d全因死亡有关,有较好的预测效能,可作为临床评估短期生存预后的重要生物标志物。Objective To analyze the application value of the variation coefficient of mean platelet volume(MPV)and percentage of neutrophils(NEU%)for predicting the all-cause death after 30 d treatment in the patients with sepsis.Methods A total of 112 patients with definitely diagnosed sepsis in this hospital from January 2018 to March 2020 were retrospectively selected and divided into the survival group and death group according to the 30 d survival outcome.Firstly,the clinical data and biochemical indexes were compared between the two groups by adopting the single factor,and then the risk factors of 30 d all-cause death were screened by the multivariate logistic regression analysis.Finally,the receiver operating characteristic(ROC)curve was used to analyze the efficiency of MPV-CV and NEU%-CV in predicting 30 d all-cause death.Results There were 80 cases in the survival group and 32 cases in the death group.The acute physiology and chronic healthⅡ(APACHEⅡ)score and sequential organ failure(SOFA)scores in the death group were increased compared with those in the survival group,the mechanical ventilation rate was increased,MPV-CV and NEU%-CV were elevated,and the differences were statistically significant(P<0.05).The Logistic regression analysis showed that the APACHEⅡscore≥18 points,SOFA score≥8 points,MPV-CV≥25%,NEU%-CV≥38%and mechanical ventilation were the risk factors of the 30 d all-cause death of the patients with sepsis(P<0.05).The ROC curve analysis showed that the AUC of MPV-CV and NEU%-CV for predicting the 30 d all-cause death of the patients with sepsis were 0.821 and 0.839 respectively(P<0.05).Conclusion The increase of MPV-CV and NEU%-CV are associated with the 30 d all-cause death of the patients with sepsis,which has better predictive efficiency and could serve as the important biomarkers for evaluating the short-term survival prognosis.

关 键 词：平均血小板体积 中性粒细胞百分比 脓毒症 全因死亡 

分 类 号：R459.7[医药卫生—急诊医学]