Gao Yanxia, Li Yi, Yu Xuezhong, Guo Shigong, Ji Xu, Sun Tongwen, Lan Chao, Lavergne Valery, Ghannoum Marc, Li Li
Emergency Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P.R.China.
Emergency Department, Peking Union Medical College Hospital, Beijing, P.R.China.
PLoS One. 2014 Aug 13;9(8):e103761. doi: 10.1371/journal.pone.0103761. eCollection 2014.
Platelet indices, including mean platelet volume (MPV), are readily available blood tests, although their prognostic value in patients with septic shock has not been fully explored. Current evidence has found contradictory results. This study aims to explore the behavior of platelet indices in septic shock and their clinical prognostic value.
Charts of septic shock patients from January to December 2012 in a tertiary medical center in Northern China were reviewed retrospectively. Platelet indices were recorded during the first five consecutive days after admission, as well as the penultimate and the last day of hospital stay. The data were compared between surviving and non-surviving patients.
A total of 124 septic shock patients were enrolled. Thirty-six of the patients survived and 88 of them expired. MPV in the non-survivor group was higher than that of the survivor group, especially on the last day. PDW and PLCR showed increased trends, while PCT and PLT decreased in the non-survivor group. Among the PLT indices, MPV had the highest area under the receiver operating characteristic curve (0.81) with a precision rate of 75.6% at a cut-off of 10.5.Compared with other more usual septic shock prognostic markers, MPV is second only to lactate for the highest area under the curve.
A statistically significant difference was seen between survivors and non-survivors for platelet indices which make them easily available and useful prognostic markers for patients in septic shock.
血小板指标,包括平均血小板体积(MPV),是易于获得的血液检测项目,尽管其在感染性休克患者中的预后价值尚未得到充分研究。目前的证据得出了相互矛盾的结果。本研究旨在探讨感染性休克患者血小板指标的变化及其临床预后价值。
回顾性分析了中国北方一家三级医疗中心2012年1月至12月期间感染性休克患者的病历。记录患者入院后连续五天以及住院倒数第二天和最后一天的血小板指标。对存活患者和非存活患者的数据进行比较。
共纳入124例感染性休克患者。其中36例患者存活,88例患者死亡。非存活组的MPV高于存活组,尤其是在最后一天。非存活组的血小板分布宽度(PDW)和血小板大细胞比率(PLCR)呈上升趋势,而降钙素原(PCT)和血小板计数(PLT)则下降。在血小板指标中,MPV在受试者工作特征曲线下的面积最大(0.81),在截断值为10.5时的准确率为75.6%。与其他更常用的感染性休克预后标志物相比,MPV在曲线下面积方面仅次于乳酸。
存活患者和非存活患者的血小板指标存在统计学上的显著差异,这使得它们成为感染性休克患者易于获得且有用的预后标志物。