Ates Hale, Ates Ihsan, Kundi Harun, Yilmaz Fatma Meric
Department of Chest Disease, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey.
J Clin Lab Anal. 2017 Sep;31(5). doi: 10.1002/jcla.22072. Epub 2016 Oct 6.
The aim of this study was to determine the hematologic parameter with the highest diagnostic differentiation in the identification of massive acute pulmonary embolism (APE).
A retrospective study was performed on patients diagnosing with APE between June 2014 and June 2016. All radiological and laboratory parameters of patients were scanned through the electronic information management system of the hospital. PLR was obtained from the ratio of platelet count to lymphocyte count, NLR was obtained from the ratio of neutrophil count to lymphocyte count, WMR was obtained from white blood cell in mean platelet volume ratio, MPR was obtained from the ratio of mean platelet volume to platelet count, and RPR was obtained from the ratio of red distribution width to platelet count.
Six hundred and thirty-nine patients consisting of 292 males (45.7%) and 347 females (54.3%) were included in the research. Independent predictors of massive risk as compared to sub-massive group were; pulmonary arterial systolic pressure (PASP) (OR=1.40; P=.001), PLR (OR=1.59; P<.001), NLR (OR=2.22; P<.001), WMR (OR=1.22; P<.001), MPR (OR=0.33; P<.001), and RPR (OR=0.68; P<.001). Upon evaluation of the diagnostic differentiation of these risk factors for massive APE by employing receiver operating characteristic curve analysis, it was determined that PLR (AUC±SE=0.877±0.015; P<.001), and NLR (AUC±SE=0.893±0.013; P<.001) have similar diagnostic differentiation in diagnosing massive APE and these two parameters are superior over PASP, MPR, WMR, and RPR.
We determined that the levels of NLR and PLR are superior to other parameters in the determination of clinical severity in APE cases.
本研究的目的是确定在识别大面积急性肺栓塞(APE)中具有最高诊断区分度的血液学参数。
对2014年6月至2016年6月期间诊断为APE的患者进行回顾性研究。通过医院电子信息管理系统扫描患者的所有放射学和实验室参数。血小板与淋巴细胞比率(PLR)通过血小板计数与淋巴细胞计数之比获得,中性粒细胞与淋巴细胞比率(NLR)通过中性粒细胞计数与淋巴细胞计数之比获得,白细胞与平均血小板体积比率(WMR)通过白细胞与平均血小板体积之比获得,平均血小板体积与血小板计数比率(MPR)通过平均血小板体积与血小板计数之比获得,红细胞分布宽度与血小板计数比率(RPR)通过红细胞分布宽度与血小板计数之比获得。
本研究纳入了639例患者,其中男性292例(45.7%),女性347例(54.3%)。与次大面积组相比,大面积风险的独立预测因素为:肺动脉收缩压(PASP)(比值比[OR]=1.40;P=0.001)、PLR(OR=1.59;P<0.001)、NLR(OR=2.22;P<0.001)、WMR(OR=1.22;P<0.001)、MPR(OR=0.33;P<0.001)和RPR(OR=0.68;P<0.001)。通过采用受试者工作特征曲线分析评估这些大面积APE风险因素的诊断区分度,确定PLR(曲线下面积±标准误[AUC±SE]=0.877±0.015;P<0.001)和NLR(AUC±SE=0.893±0.013;P<0.001)在诊断大面积APE方面具有相似的诊断区分度,且这两个参数优于PASP、MPR、WMR和RPR。
我们确定在APE病例临床严重程度的判定中,NLR和PLR水平优于其他参数。