平均血小板体积与颅内动脉瘤介入栓塞术后复发的相关性研究  

Association between mean platelet volume and the recurrence in patients with intracranial aneurysm after endovascular intervention

作　　者：张孝军[1] 舒仲文 郭红根 郑智淼 杨立馨 陈刘炜 李茂全[1] ZHANG Xiaojun;SHU Zhongwen;GUO Honggen;ZHENG Zhimiao;YANG Lixin;CHEN Liuwei;LI Maoquan(Department of Interventional Vascular Surgery,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China;Department of Neurosurgery,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院介入血管外科,上海200072 [2]同济大学附属第十人民医院神经外科,上海200072

出　　处：《同济大学学报（医学版）》2023年第4期511-518,共8页Journal of Tongji University(Medical Science)

摘　　要：目的探究平均血小板体积(mean platelet volume,MPV)大小与颅内动脉瘤栓塞术后复发的关系。方法回顾性地收集并分析了2016年1月—2021年1月接受动脉瘤介入治疗的388例患者共424个颅内动脉瘤的临床资料。所有患者初次发病入院时检测MPV数值。根据随访期间有无复发将动脉瘤分成两组,使用单因素分析和多因素Logistic回归分析来探究MPV与动脉瘤栓塞术后复发的关系。绘制受试者工作特征(receiver operating characteristic,ROC)曲线来评估MPV对于动脉瘤复发的预测能力。结果有79例(18.6%)动脉瘤出现了复发。根据有无复发将所有的动脉瘤分成两组。单因素分析表明,两组间年龄、破裂动脉瘤比例、术前改良Fisher分级、栓塞方式、栓塞即刻Raymond-Roy分级和入院MPV大小差异有统计学意义(均P<0.05)。多因素Logistic回归分析表明,即刻栓塞结果(OR=4.464,95%CI:2.2428.890,P<0.001)和入院MPV数值(OR=0.238,95%CI:0.1620.350,P<0.001)是动脉瘤复发的独立预测因子。ROC曲线分析表明,MPV预测动脉瘤复发的曲线下面积为0.828(95%CI:0.7890.863,P<0.001)。MPV预测动脉瘤复发的最佳截断值为9.9 fL。MPV≤9.9 fL对于预测动脉瘤复发具有78.5%的灵敏度和80.0%的特异度。结论MPV水平对颅内动脉瘤介入栓塞后复发具有预测潜力,入院MPV越低的患者,其复发可能性越大。Objective To explore the association between aneurysm recurrence and mean platelet volume(MPV)in patients receiving endovascular embolization for intracranial aneurysms.Methods Clinical data 388 patients with intracranial aneurysms(424 lesions)who received endovascular embolization in our institution between January 2016 and January 2021 were retrospectively analyzed.The MPV were measured at admission.During the follow-up,the recurrence occurred in 79 aneurysms(recurrence group)and there was no recurrence in 345 aneurysms(non-recurrent group).Univariate analysis and multivariate Logistic regression analysis were performed to investigate the risk factors of aneurysm recurrence.The predictive value of MPV for predicting aneurysm recurrence was assessed with receiver operating characteristic(ROC)curve.Results Univariate analysis demonstrated that the recurrence of aneurysms were significantly associated with younger age of patients,ruptured aneurysms,higher modified Fisher grades,lower portion of stent-assisted coiling,lower rate of complete obliteration,and lower MPV values(all P<0.05).The multivariate Logistic regression analysis showed that the Raymond-Roy classification(OR=4.464,95%CI:2.242-8.890,P<0.001)and MPV(OR=0.238,95%CI:0.162-0.350,P<0.001)were independent predictor for the recurrence of aneurysm.The area under ROC curve(AUC)of MPV for predicting the recurrence of aneurysm was 0.828(95%CI:0.789-0.863,P<0.001);the optimal cut-off value for MPV to predict aneurysm recurrence was 9.9 fL with a sensitivity of 78.5%and a specificity of 80.0%.Conclusion Low MPV is associated with the recurrence of intracranial aneurysm in patients receiving endovascular embolization.

关 键 词：平均血小板体积 动脉瘤复发 颅内动脉瘤 血管内治疗 

分 类 号：R739.41[医药卫生—肿瘤]