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MPV与血浆N末端B型利钠肽原联合简化日内瓦量表对急性肺栓塞预后的预测价值

Predictive Value of MPV and Plasma NT-ProBNP Combined with the Simplified Geneva Scale for the Prognosis of Acute Pulmonary Embolism.

作者信息

Wang Jing, Wang Lu, Jin Ling, Rong Xiaolei, Tang Xueshuang, Guo Haina, Liu Xiaochuan, Shi Lei, Tao Guilu

机构信息

Department of Wound Repairment and Intervention, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116000, China.

Department of Internal Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116000, China.

出版信息

Evid Based Complement Alternat Med. 2021 Oct 19;2021:1292921. doi: 10.1155/2021/1292921. eCollection 2021.

Abstract

OBJECTIVE

To explore the predictive value of mean platelet volume (MPV) and plasma -terminal probrain natriuretic peptide (NT-ProBNP) combined with a simplified Geneva scale for the prognosis of acute pulmonary embolism (APE).

METHODS

The clinical data of 68 patients with APE admitted to our hospital from October 2017 to October 2019 were collected. According to the prognosis, the patients were divided into a good prognosis group ( = 45) and a poor prognosis group ( = 23). The clinical data, laboratory clinical indexes, and simplified Geneva scale scores were recorded for the two groups. The risk factors of poor prognosis were analyzed by binary multivariate logistic regression analysis; the predictive ability of each index on the prognosis of patients with APE was analyzed by the ROC curve.

RESULTS

The incidences of deep vein thrombosis, diabetes, and hyperlipidemia in the poor prognosis group were higher than those in the good prognosis group ( < 0.05). PLT, platelet distribution width (PDW), MPV, and plasma NT-ProBNP in the poor prognosis group were higher than those in the good prognosis group ( < 0.05). The simplified Geneva scale score of the poor prognosis group was higher than that of the good prognosis group ( < 0.05). PDW, MPV, plasma NT-ProBNP, and simplified Geneva scale were all independent risk factors for the poor prognosis of APE patients ( < 0.05). The AUC of MPV in predicting the prognosis of APE patients was 0.818 (95% CI: 0.712-0.925). When the optimal cutoff value was 0.571, the sensitivity was 77.1%, and the specificity was 80.0%. The AUC of plasma NT-ProBNP in predicting the prognosis of APE patients was 0.762 (95% CI: 0.634-0.891). When the optimal cutoff value was 0.475, the sensitivity was 71.5%, and the specificity was 76.0%. The AUC of the simplified Geneva scale in predicting the prognosis of APE patients was 0.749 (95% CI: 0.618-0.879). When the optimal cutoff value was 0.469, the sensitivity was 82.9%, and the specificity was 64.0%. The AUC of MPV and plasma NT-ProBNP combined with the simplified Geneva scale in predicting the prognosis of APE patients was 0.907 (95% CI: 0.826-0.988). When the optimal cutoff value was 0.726, the sensitivity was 88.6%, and the specificity was 84.0%.

CONCLUSION

MPV, plasma NT-ProBNP, and simplified Geneva scale have a certain predictive value for the prognosis of APE. Compared with a single index, the combination of the three indexes has a significant improvement in predicting the prognosis of APE and has better clinical value.

摘要

目的

探讨平均血小板体积(MPV)、血浆N末端脑钠肽前体(NT-ProBNP)联合简化日内瓦评分对急性肺栓塞(APE)预后的预测价值。

方法

收集2017年10月至2019年10月我院收治的68例APE患者的临床资料。根据预后情况,将患者分为预后良好组(n = 45)和预后不良组(n = 23)。记录两组患者的临床资料、实验室临床指标及简化日内瓦评分。采用二元多因素logistic回归分析预后不良的危险因素;通过ROC曲线分析各指标对APE患者预后的预测能力。

结果

预后不良组深静脉血栓形成、糖尿病及高脂血症的发生率高于预后良好组(P < 0.05)。预后不良组的血小板计数(PLT)、血小板分布宽度(PDW)、MPV及血浆NT-ProBNP均高于预后良好组(P < 0.05)。预后不良组的简化日内瓦评分高于预后良好组(P < 0.05)。PDW、MPV、血浆NT-ProBNP及简化日内瓦评分均为APE患者预后不良的独立危险因素(P < 0.05)。MPV预测APE患者预后的AUC为0.818(95%CI:0.712 - 0.925)。当最佳截断值为0.571时,敏感度为77.1%,特异度为80.0%。血浆NT-ProBNP预测APE患者预后的AUC为0.762(95%CI:0.634 - 0.891)。当最佳截断值为0.475时,敏感度为71.5%,特异度为76.0%。简化日内瓦评分预测APE患者预后的AUC为0.749(95%CI:0.618 - 0.879)。当最佳截断值为0.469时,敏感度为82.9%,特异度为64.0%。MPV和血浆NT-ProBNP联合简化日内瓦评分预测APE患者预后的AUC为0.907(95%CI:0.826 - 0.988)。当最佳截断值为0.726时,敏感度为88.6%,特异度为84.0%。

结论

MPV、血浆NT-ProBNP及简化日内瓦评分对APE的预后有一定的预测价值。与单一指标相比,三项指标联合对APE预后的预测有显著改善,具有较好的临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f91/8548102/fc12d5d91fcf/ECAM2021-1292921.001.jpg

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