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血小板衍生微粒在肺血栓栓塞症中的诊断价值:一项基于人群的研究。

Diagnostic value of platelet-derived microparticles in pulmonary thromboembolism: A population-based study.

作者信息

Wang Minglian, Fu Yingyun, Xu Lan, Xiao Lu, Yue Yongjian, Liu Shengguo, Huang Qijun, Li Shulin, Li Yazhen

机构信息

Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.

Shenzhen Key Laboratory of Respiratory Disease, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.

出版信息

Exp Ther Med. 2018 Oct;16(4):3099-3106. doi: 10.3892/etm.2018.6579. Epub 2018 Aug 7.

Abstract

An early and accurate diagnosis of pulmonary thromboembolism (PTE) remains challenging. The present study aimed to evaluate the diagnostic value of platelet-derived microparticles in PTE based on a population study. A total of 102 patients with PTE, 102 healthy controls and 40 patients suspected with PTE were enrolled in this study. The platelet count, mean platelet volume and platelet distribution width were assessed using an automated hematology analyzer, P-selectin was assessed using an ELISA kit and PMPs were explored using flow cytometry using Megamix beads. Receiver operating characteristic curves were established to evaluate the diagnostic values of PMPs, D-dimer, PMPs combined with D-dimer, and multiple parameters (including PMPs, platelet distribution width, P-selectin and D-dimer in PTE). The PMP levels were significantly higher in the patients with PTE (609.10/µl) compared with those in the healthy controls (230.60/µl) and patients with suspicious PTE (166.70/µl; P<0.01). The accuracy (72.06%) of PMPs in the diagnosis of PTE was similar to those of D-dimer (P>0.05). The combination of D-dimer and PMPs significantly increased the sensitivity (86.27%) of D-dimer and the specificity of PMP for the diagnosis of PTE (P<0.01). The combination of PMPs, platelet distribution width, P-selectin and D-dimer exhibited high sensitivity (88.24%), specificity (91.18%) and accuracy (89.71%) in the diagnosis of PTE. These findings suggest that elevated PMP levels are an effective predictor of PTE. The combination of PMPs, platelet distribution width, P-selectin and D-dimer may be used in the diagnosis of PTE with high sensitivity and specificity.

摘要

早期准确诊断肺血栓栓塞症(PTE)仍然具有挑战性。本研究旨在基于一项人群研究评估血小板衍生微粒在PTE中的诊断价值。本研究共纳入102例PTE患者、102例健康对照者和40例疑似PTE患者。使用自动血液分析仪评估血小板计数、平均血小板体积和血小板分布宽度,使用ELISA试剂盒评估P-选择素,并使用Megamix微球通过流式细胞术检测血小板衍生微粒(PMPs)。建立受试者工作特征曲线以评估PMPs、D-二聚体、PMPs联合D-二聚体以及多个参数(包括PTE中的PMPs、血小板分布宽度、P-选择素和D-二聚体)的诊断价值。与健康对照者(230.60/µl)和疑似PTE患者(166.70/µl;P<0.01)相比,PTE患者的PMP水平显著更高(609.10/µl)。PMPs诊断PTE的准确性(72.06%)与D-二聚体相似(P>0.05)。D-二聚体与PMPs联合使用可显著提高D-二聚体的敏感性(86.27%)和PMP对PTE诊断的特异性(P<0.01)。PMPs、血小板分布宽度、P-选择素和D-二聚体联合使用在PTE诊断中表现出高敏感性(88.24%)、特异性(91.18%)和准确性(89.71%)。这些发现表明,PMP水平升高是PTE的有效预测指标。PMPs、血小板分布宽度、P-选择素和D-二聚体联合使用可用于PTE的诊断,具有高敏感性和特异性。

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