Ma Lijie, Han Qiuxia, Sun Fang, Zhu Kaiyi, Sun Qianmei
Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China.
Int J Gen Med. 2023 Sep 1;16:3985-3994. doi: 10.2147/IJGM.S416817. eCollection 2023.
This study aimed to explore whether the mean platelet volume/platelet count ratio (MPR) has predictive value for the occurrence and prognosis of acute ischemic stroke (AIS) in hemodialysis patients.
A total of 402 patients undergoing maintenance hemodialysis were screened and 259 were enrolled in this study. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the predictive power of the models. The patients enrolled in this study were divided into three groups based on the tertiles of the MPR value (Q1, Q2, and Q3). Kaplan-Meier curves were used to investigate the association between the MPR and AIS-free survival in hemodialysis patients. Chi-square analysis was performed to explore the association between the MPR and AIS outcomes in hemodialysis patients. And the AIS outcome was assessed using the modified Rankin Scale (mRS).
MPR had a predictive value for the occurrence of AIS (AUC=0.814) in hemodialysis patients with a high sensitivity and specificity. AIS-free survival rates in the MPR Q1, MPR Q2, and MPR Q3 groups were 0.930, 0.701, and 0.360, respectively. The proportion of patients with good outcomes (mRS 0-2) was significantly greater among patients in the MPR Q1-Q2 group than in the MPR Q3 group (0.844 vs 0.745, p <0.001).
The MPR can be used as a good predictor of AIS in patients undergoing hemodialysis. Patients on hemodialysis with increased MPR levels had a higher incidence of AIS and poorer functional outcomes than those with low MPR levels.
本研究旨在探讨平均血小板体积/血小板计数比值(MPR)对血液透析患者急性缺血性卒中(AIS)的发生及预后是否具有预测价值。
共筛选出402例接受维持性血液透析的患者,其中259例纳入本研究。采用受试者工作特征曲线及曲线下面积(AUC)评估模型的预测能力。根据MPR值的三分位数将本研究纳入的患者分为三组(Q1、Q2和Q3)。采用Kaplan-Meier曲线研究MPR与血液透析患者无AIS生存之间的关联。进行卡方分析以探讨MPR与血液透析患者AIS结局之间的关联。并使用改良Rankin量表(mRS)评估AIS结局。
MPR对血液透析患者AIS的发生具有预测价值(AUC=0.814),具有较高的敏感性和特异性。MPR Q1组、MPR Q2组和MPR Q3组的无AIS生存率分别为0.930、0.701和0.360。MPR Q1-Q2组患者中预后良好(mRS 0-2)的比例显著高于MPR Q3组(0.844对0.745,p<0.001)。
MPR可作为血液透析患者AIS的良好预测指标。MPR水平升高的血液透析患者AIS的发生率高于MPR水平低的患者,且功能结局较差。