Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
Department of Laboratory, Yibin Sixth People's Hospital, Chengdu, Sichuan, China.
Brain Behav. 2024 May;14(5):e3509. doi: 10.1002/brb3.3509.
The purpose of this study was to investigate the predictive value of mean platelet volume (MPV) and platelet count (PC) in branch atheromatous disease (BAD).
This retrospective study included 216 patients with BAD-stroke within 48 h of symptom onset. These patients were divided into good and poor prognosis groups according to their 3-month modified Rankin scale scores after discharge. Multiple logistic regression analysis was used to evaluate independent predictors of poor prognosis in BAD-stroke patients. Receiver-operating characteristic (ROC) analysis was used to estimate the predictive value of MPV and PC on BAD-stroke.
Our research showed that a higher MPV (aOR, 2.926; 95% CI, 2.040-4.196; p < .001) and PC (aOR, 1.013; 95% CI, 1.005-1.020; p = .001) were independently associated with poor prognosis after adjustment for confounders. The ROC analysis of MPV for predicting poor prognosis showed that the sensitivity and specificity were 74% and 84.9%, respectively, and that the AUC was .843 (95% CI, .776-.909, p < .001). The optimal cut-off value was 12.35. The incidence of early neurological deterioration (END) was 24.5% (53 of 163), and 66% of patients in the poor prognosis group had END (33 of 50). Multiple logistic regression analyses showed that elevated MPV and PC were associated with the occurrence of END (p < .05).
Our results suggested that an elevated MPV and PC may be important in predicting a worse outcome in BAD-stroke patients. Our study also demonstrated an independent association of MPV and PC with END, which is presumably the main reason for the poor prognosis.
本研究旨在探讨平均血小板体积（MPV）和血小板计数（PC）对分支粥样硬化性疾病（BAD）的预测价值。
本回顾性研究纳入了 216 例发病后 48 小时内发生 BAD 卒中的患者。根据出院后 3 个月改良 Rankin 量表评分，将这些患者分为预后良好组和预后不良组。采用多因素 logistic 回归分析评估 BAD 卒中患者预后不良的独立预测因素。采用受试者工作特征（ROC）曲线分析评估 MPV 和 PC 对 BAD 卒中的预测价值。
本研究表明，较高的 MPV（比值比，2.926；95%置信区间，2.040-4.196；p<0.001）和 PC（比值比，1.013；95%置信区间，1.005-1.020；p=0.001）与调整混杂因素后的不良预后独立相关。MPV 预测不良预后的 ROC 分析显示，敏感性和特异性分别为 74%和 84.9%，曲线下面积为 0.843（95%置信区间，0.776-0.909，p<0.001）。最佳截断值为 12.35。早期神经功能恶化（END）的发生率为 24.5%（53/163），预后不良组中有 66%（50/76）的患者发生 END。多因素 logistic 回归分析显示，MPV 和 PC 升高与 END 的发生相关（p<0.05）。
我们的结果表明，MPV 和 PC 升高可能对预测 BAD 卒中患者的不良预后具有重要意义。本研究还表明，MPV 和 PC 与 END 独立相关，这可能是预后不良的主要原因。
