MPVLR与消化性溃疡并发上消化道出血的关系  

Association between mean platelet volume-to-lymphocyte ratio and peptic ulcer complicated by upper gastrointestinal bleeding

作　　者：张莹[1] 张生燕 孟敏[1] 王秀敏[1] ZHANG Ying;ZHANG Shengyan;MENG Min;WANG Xiumin(Department of Gastroenterology,Anyang People’s Hospital,Anyang 455002,China)

机构地区：[1]安阳市人民医院消化内科,河南安阳455002

出　　处：《青岛大学学报（医学版）》2024年第5期747-750,共4页Journal of Qingdao University(Medical Sciences)

基　　金：河南省医学科技攻关计划项目(LH-GJ20210582)。

摘　　要：目的探讨平均血小板体积/淋巴细胞比值(MPVLR)与消化性溃疡(PU)并发上消化道出血(UGIB)的关系及其意义。方法将2021年6月—2023年6月安阳市人民医院诊治的233例PU病人作为研究组,另取同期体检健康人群210例为对照组。受试者入院后24 h内检测平均血小板体积(MPV)、淋巴细胞计数(LYM),并计算MPVLR。根据PU病人随访期间是否并发UGIB分为UGIB组(72例)及非UGIB组(161例)。采用受试者工作特性(ROC)曲线评估MPVLR对PU并发UGIB的诊断价值,采用多因素Logistic回归分析影响PU并发UGIB的危险因素。结果研究组MPVLR明显高于对照组(t=70.287,P<0.05)。UGIB组MPVLR明显高于非UGIB组(t=26.566,P<0.05)。ROC曲线分析显示,MPVLR诊断PU病人并发UGIB的曲线下面积为0.741(95%CI=0.761~0.861)。多因素Logistic逐步回归分析显示,使用非甾体类抗炎药物(OR=2.423,95%CI=1.650~3.558)、幽门螺杆菌感染(OR=3.047,95%CI=1.802~5.151)以及MPVLR(OR=3.762,95%CI=2.001~7.072)均为影响PU并发UGIB的危险因素(P<0.05)。结论MPVLR在PU并发UGIB病人中异常升高,对UGIB发生具有较高的预测价值。Objective To investigate the association between mean platelet volume-to-lymphocyte ratio(MPVLR)and upper gastrointestinal bleeding(UGIB)in patients with peptic ulcer(PU).Methods A total of 233 patients with PU who were diagnosed and treated in Anyang People’s Hospital from June 2021 to June 2023 were enrolled as study group,and 210 healthy individuals who underwent physical examination during the same period of time were enrolled as control group.Mean platelet volume(MPV)and lymphocyte count(LYM)were measured within 24 hours after admission,and MPVLR was calculated.According to the presence or absence of UGIB during follow-up,the patients with PU were divided into UGIB group with 72 patients and non-UGIB group with 161 patients.The receiver operating characteristic(ROC)curve was used to assess the value of MPVLR in the diagnosis of PU complicated by UGIB,and the multivariate Logistic regression analysis was used to investigate the risk factors for PU complicated by UGIB.Results The study group had a significantly higher MPVLR than the control group(t=70.287,P<0.05),and the UGIB group had a significantly higher MPVLR than the non-UGIB group(t=26.566,P<0.05).The ROC curve analysis showed that MPVLR had an area under the ROC curve of 0.741(95%CI=0.761-0.861)in the diagnosis of UGIB in patients with PU.The multivariate Logistic stepwise regression analysis showed that the use of nonsteroidal anti-inflammatory drugs(OR=2.423,95%CI=1.650-3.558,P<0.05),Helicobacter pylori infection(OR=3.047,95%CI=1.802-5.151,P<0.05),and MPVLR(OR=3.762,95%CI=2.001-7.072,P<0.05)were risk factors for PU complicated by UGIB.Conclusion There is an abnormal increase in MPVLR in patients with PU,with has a high predictive value for UGIB.

关 键 词：消化性溃疡出血 平均血小板体积 淋巴细胞计数 危险因素 LOGISTIC模型 

分 类 号：R573.2[医药卫生—消化系统] R446.11[医药卫生—内科学]