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入院时平均血小板体积增加可预测 ICU 肺炎患者的预后:一项回顾性研究。

An increase in mean platelet volume during admission can predict the prognoses of patients with pneumonia in the intensive care unit: A retrospective study.

机构信息

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Pulmonology, Cheonan Chungmu Hospital, Cheonan, Korea.

出版信息

PLoS One. 2018 Dec 11;13(12):e0208715. doi: 10.1371/journal.pone.0208715. eCollection 2018.

Abstract

Platelets play an important role in hemostasis, inflammation, and immunity. Mean platelet volume (MPV), considered a marker of platelet function and activation, is associated with increased morbidity and mortality in sepsis, coronary artery disease, and chronic inflammatory disease. However, the clinical characteristics and prognostic significance of MPV changes for patients with pneumonia in the intensive care unit (ICU) have not been investigated. This retrospective study was conducted using data from an operational database of patients admitted to a medical ICU between October 2010 and October 2017. Of 235 adult patients with pneumonia admitted to the ICU, clinical characteristics and in-hospital mortality values were compared according to MPV, ΔMPVday1-2, ΔMPVday1-3, ΔMPVday1-4, and ΔMPVday1-Discharge between those who survived and those who did not. The MPV increased during the first four days for both non-survivors and survivors (P < 0.001). However, repeated measures analysis of variance revealed a significantly higher MPV rate over the first four days in non-survivors than in survivors. Additionally, the ΔMPVday1-2, ΔMPVday1-3, ΔMPVday1-4, and ΔMPVday1-Discharge values were significantly greater in non-survivors than in survivors. For in-hospital mortality, the optimal ΔMPV values were >0.9 fL, P = 0.020; >0.9 fL, P < 0.001; >0.8 fL, P < 0.001; and >1.3 fL, P < 0.001 on day 2, day 3, day 4, and at discharge, respectively. In conclusion, our findings demonstrate that ΔMPV during ICU admission may be used as a prognostic marker of mortality in ICU patients with pneumonia. Repeated MPV measurements throughout hospitalization may improve risk stratification for these patients, which could aid in improving patient outcomes.

摘要

血小板在止血、炎症和免疫中发挥重要作用。平均血小板体积(MPV)被认为是血小板功能和活化的标志物,与脓毒症、冠心病和慢性炎症性疾病的发病率和死亡率增加有关。然而,尚未研究 ICU 中肺炎患者血小板体积变化的临床特征和预后意义。本回顾性研究使用 2010 年 10 月至 2017 年 10 月期间入住内科 ICU 的患者的运营数据库中的数据进行。在 235 名入住 ICU 的成人肺炎患者中,根据 MPV、ΔMPVday1-2、ΔMPVday1-3、ΔMPVday1-4 和ΔMPVday1-Discharge,比较了存活者和非存活者的临床特征和院内死亡率值。非存活者和存活者的 MPV 在头四天均升高(P<0.001)。然而,重复测量方差分析显示,非存活者在前四天的 MPV 升高率明显高于存活者。此外,非存活者的ΔMPVday1-2、ΔMPVday1-3、ΔMPVday1-4 和ΔMPVday1-Discharge 值明显大于存活者。对于院内死亡率,最佳ΔMPV 值分别为>0.9 fL,P=0.020;>0.9 fL,P<0.001;>0.8 fL,P<0.001;和>1.3 fL,P<0.001,分别在第 2 天、第 3 天、第 4 天和出院时。总之,我们的研究结果表明,ICU 入院期间的ΔMPV 可作为 ICU 肺炎患者死亡率的预后标志物。整个住院期间重复测量 MPV 可能会改善这些患者的风险分层,从而有助于改善患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92a2/6289458/cd6c26aab602/pone.0208715.g001.jpg

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