Huang Jianqiang, Chen Yanyan, Cai Zhixiong, Chen Ping
Department of Cardiovascular Medicine, Shantou Central Hospital, Shantou City, Guangdong, China.
Department of Cardiovascular Medicine, Shantou Central Hospital, Shantou City, Guangdong, China.
Am J Emerg Med. 2015 Jun;33(6):760-3. doi: 10.1016/j.ajem.2015.02.043. Epub 2015 Mar 4.
The aims of the study are to investigate the changes in platelet indexes, including platelet count, platelet distribution width (PDW), and mean platelet volume (MPV), in patients with pulmonary embolism (PE) and to evaluate their diagnostic values in relation to this disease.
The study included 70 patients with PE as the observation group and 75 patients without PE as the control group. The differences in platelet count, PDW, MPV, d-dimer, and other indicators between the 2 groups were retrospectively analyzed.
Platelet distribution width and MPV were significantly higher in patients with PE than in the controls (16.40% [13.70%-16.85%] vs 16.00% [11.28%-16.60%], P = .023; 9.91 ± 1.40 fL. vs 8.84 ± 1.68 fL, P < .001, respectively). Multivariate logistic regression analysis showed that MPV and d-dimer were independent influencing factors for the diagnosis of PE. Receiver operating characteristic curve analysis showed that MPV (with the cut-off value set at 8.45 fL) had a sensitivity of 88.7%, negative predictive value of 78.7%, specificity of 50.0%, and positive predictive value of 61.9%. d-Dimer (with the cut-off value set at 835.5 μg/L) had a sensitivity of 80.6%, negative predictive value of 77.8%, specificity of 62.1%, and positive predictive value of 66.7%. The combination of d-dimer and MPV resulted in an increase in the area under the curve (0.799; 95% confidence interval, 0.724-0.874; P < .001).
Higher PDW and MPV levels are noticed in patients with PE. The combined application of MPV can improve the diagnostic value of d-dimer for PE.
本研究旨在调查肺栓塞（PE）患者血小板指标的变化，包括血小板计数、血小板分布宽度（PDW）和平均血小板体积（MPV），并评估其对该疾病的诊断价值。
本研究纳入70例PE患者作为观察组，75例无PE患者作为对照组。回顾性分析两组患者血小板计数、PDW、MPV、D-二聚体等指标的差异。
PE患者的血小板分布宽度和MPV显著高于对照组（分别为16.40%[13.70%-16.85%]对16.00%[11.28%-16.60%]，P = 0.023；9.91±1.40 fL对8.84±1.68 fL，P < 0.001）。多因素logistic回归分析显示，MPV和D-二聚体是PE诊断的独立影响因素。受试者工作特征曲线分析显示，MPV（截断值设定为8.45 fL）的灵敏度为88.7%，阴性预测值为78.7%，特异性为50.0%，阳性预测值为61.9%。D-二聚体（截断值设定为835.5μg/L）的灵敏度为80.6%，阴性预测值为77.8%，特异性为62.1%，阳性预测值为66.7%。D-二聚体和MPV联合应用使曲线下面积增加（0.799；95%置信区间，0.724-0.874；P < 0.001）。
PE患者的PDW和MPV水平较高。MPV的联合应用可提高D-二聚体对PE的诊断价值。
