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血小板指标能否预测急性肺栓塞患者肺血管床的阻塞程度?

Can platelet indices predict obstruction level of pulmonary vascular bed in patients with acute pulmonary embolism?

作者信息

Günay Ersin, Sarinc Ulasli Sevinc, Kacar Emre, Halici Bilal, Unlu Ebru, Tünay Kamil, Ozkececi Gulay, Koken Tulay, Unlu Mehmet

机构信息

Department of Pulmonary Diseases, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.

出版信息

Clin Respir J. 2014 Jan;8(1):33-40. doi: 10.1111/crj.12031. Epub 2013 Jul 31.

Abstract

INTRODUCTION

Computed tomography pulmonary arterial obstruction index ratio (CTPAOIR) is related with the severity of pulmonary embolism (PE). Platelet indices including mean platelet volume (MPV), platelet distribution width (PDW) are reported to be increased in acute PE.

OBJECTIVE

In this study, we aimed to evaluate the relationship between CTPAOIR and platelet indices and the utility of these parameters in the determination of PE severity.

MATERIALS AND METHODS

We retrospectively analysed the demographic data, clinical probability scores, laboratory data and echocardiographic findings of 63 acute PE patients who were diagnosed by pulmonary arterial computed tomography angiography.

RESULTS

The hospital records of 38 (60.3%) male and 25 (39.7%) female patients with acute PE and 29 (58%) male and 21 (42%) female healthy control were evaluated (P = 0.803). The mean value of MPV, PDW levels, platelet counts and red cell distribution width levels were higher in PE groups than in control subjects (P < 0.05). Massive PE was present in 33.3% of PE patients. There were statistically significant differences in terms of hospital length of stay (HLS), mean value of MPV, CTPAOIR and systolic pulmonary arterial pressure (sPAP) in addition to systolic arterial pressure between massive and submassive PE patients (P < 0.05 for all). CTPAOIR was positively correlated with HLS, clinical probability scores, D-Dimer level, MPV, PDW levels and sPAP.

CONCLUSION

Platelet indices, MPV and PDW, can be used for the determination of disease severity, and lead to therapeutic strategies for PE patients.

摘要

引言

计算机断层扫描肺动脉阻塞指数比(CTPAOIR)与肺栓塞(PE)的严重程度相关。据报道,急性PE患者的血小板指标包括平均血小板体积(MPV)、血小板分布宽度(PDW)会升高。

目的

在本研究中,我们旨在评估CTPAOIR与血小板指标之间的关系,以及这些参数在确定PE严重程度方面的效用。

材料与方法

我们回顾性分析了63例经肺动脉计算机断层扫描血管造影诊断为急性PE患者的人口统计学数据、临床概率评分、实验室数据和超声心动图检查结果。

结果

评估了38例(60.3%)男性和25例(39.7%)女性急性PE患者以及29例(58%)男性和21例(42%)女性健康对照者的医院记录(P = 0.803)。PE组的MPV、PDW水平、血小板计数和红细胞分布宽度水平的平均值高于对照组(P < 0.05)。33.3%的PE患者存在大面积PE。除收缩压外,大面积和次大面积PE患者在住院时间(HLS)、MPV平均值、CTPAOIR和收缩期肺动脉压(sPAP)方面存在统计学显著差异(所有P均< 0.05)。CTPAOIR与HLS、临床概率评分、D - 二聚体水平、MPV、PDW水平和sPAP呈正相关。

结论

血小板指标MPV和PDW可用于确定疾病严重程度,并为PE患者制定治疗策略。

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