抗栓前后血小板参数对非心源性脑梗死预后预测价值研究
作者:
作者单位:

常德市第一人民医院,湖南 常德 415003

作者简介:

孙淑君(1987-),女,主治医师,硕士,主要从事脑血管意外的研究。

通信作者:

徐平(1963-),男,主任医师,学士,主要从事脑血管意外方面的研究。Email:1301154724@qq.com。

基金项目:


Predictive value of platelet parameters before and after antithrombotic treatment for outcome of non-cardiogenic cerebral infarction
Author:
Affiliation:

Department of Neurology, Changde First People's Hospital, Changde, Hunan 415003, China

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    摘要:

    目的 探讨抗栓前及抗栓7 d后血小板计数(PC)、平均血小板体积(MPV)、血小板分布宽度(PDW)及MVP/PC比值和PDW/PC比值在急性非心源性脑梗死(NCCI)中是否具有预测预后的价值。方法 纳入2018年12月—2019年7月入住常德市第一人民医院神经内科142例NCCI患者,均在入院第1天抗栓前行PC、MPV、PDW检测。抗栓后第7天,有94例患者完善了PC、MPV、PDW复查。采用改良Rankin量表(MRS)评估患者6个月时神经功能恢复状态,并将其分为预后良好组(MRS≤2分)及预后不良组(MRS>2分),比较上述血小板参数在两组之间的差异。结果 不良预后组抗栓前的PC低于预后良好组(P <0.05),而抗栓前MPV/PC、抗栓后MPV、MPV/PC、PDW、PDW/PC高于预后良好组(P <0.05)。多因素Logistics回归分析发现抗栓治疗7 d后的MPV为NCCI不良预后的危险因素(R=7.669, 95%CI=1.527~38.528)。ROC曲线提示抗栓后MPV具有预测价值,最佳临界值是10.13fl,曲线下面积(AUC)0.787(P <0.05),灵敏度83.33%,特异度69.50%。结论 抗栓治疗7 d后的MPV值为NCCI预后不良的危险因素,对其有预测价值。 [国际神经病学神经外科学杂志, 2021, 48(1): 55-58]

    Abstract:

    Objective To investigate the predictive value for acute non-cardiogenic cerebral infarction (NCCI) outcome of platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), MPV/PC ratio, and PDW/PC ratio before and 7 days after antithrombotic treatment.Methods We enrolled 142 patients with NCCI who were hospitalized in the Department of Neurology of the First People’s Hospital of Changde City from December 2018 to July 2019. PC, MPV, and PDW were measured for all the patients on the first day of hospitalization before antithrombotic treatment, and were re-measured in 94 patients on the seventh day of antithrombotic treatment. The Modified Rankin Scale (MRS) was used to evaluate neurological recovery 6 months after disease onset. The patients were divided into good-outcome group (MRS≤2) and poor-outcome group (MRS>2). The platelet parameters were compared between the two groups.Results Compared with the good-outcome group, the poor-outcome group had significantly lower PC before antithrombotic treatment, significantly higher MPV/PC before antithrombotic treatment, and significantly higher MPV, MPV/PC, PDW, and PDW/PC after antithrombotic treatment. Multivariate logistic regression analysis showed that MPV on day 7 of antithrombotic treatment was a risk factor for a poor outcome of NCCI (odds ratio=7.669, 95% confidence interval: 1.527-38.528, P <0.05). According to the receiver operating characteristic curve, MPV had predictive value; the cut-off value was 10.13 fl, and the area under the curve was 0.787 (P <0.05), with a sensitivity of 83.33% and a specificity of 69.50%.Conclusions MPV on day 7 of antithrombotic treatment is a predictive risk factor for a poor outcome of NCCI.Journal of International Neurology and Neurosurgery, 2021, 48(1): 55-58]

    表 1 预后良好组与预后不良组一般资料比较Table 1
    表 2 NCCI预后不良危险因素分析Table 2
    图1 ROC曲线分析MPV7的NCCI不良预后预测价值Fig.1
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孙淑君,王茹莹,钟真真,文俊,徐平456.抗栓前后血小板参数对非心源性脑梗死预后预测价值研究[J].国际神经病学神经外科学杂志,2021,48(1):55-58111SUN Shu-Jun, WANG Ru-Ying, ZHONG Zhen-Zhen, WEN Jun, XU Ping222. Predictive value of platelet parameters before and after antithrombotic treatment for outcome of non-cardiogenic cerebral infarction[J]. Journal of International Neurology and Neurosurgery,2021,48(1):55-58

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  • 收稿日期:2020-07-14
  • 最后修改日期:2021-01-01
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  • 在线发布日期: 2021-06-03
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