平均血小板容积对rtPA静脉溶栓治疗的缺血性脑卒中病人预后的预测价值
The predict value of the mean platelet volume on prognosis of the ischemic stroke patients treated with rtPA intravenous thrombolysis
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摘要: 目的：探讨平均血小板容积（MPV）对重组组织型纤溶酶原激活剂（rtPA）静脉溶栓治疗的缺血性脑卒中病人预后的预测价值。方法：采用改良Rankin量表（MRS）评价rtPA溶栓治疗病人预后状况，分为预后良好组和预后不良组，探讨MPV对溶栓治疗的预后的影响。结果：2组病人年龄、房颤发生率、既往服用阿司匹林、收缩压、舒张压、NIHSS评分、INR、血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板压积、MPV、血小板分布宽度和CISS分型差异均有统计学意义（P<0.05~P<0.01）。logistic回归分析结果显示，年龄、既往服用阿司匹林、基线NIHSS评分、血糖、低密度脂蛋白胆固醇、MPV、血小板分布宽度、心源性卒中型及穿支动脉疾病型均为rtPA溶栓治疗预后的独立影响因素（P<0.05~P<0.01）。线性回归分析结果显示，MPV与MRS评分呈负相关关系（r=-0.435，P<0.05），MPV诊断rtPA溶栓治疗预后的最佳临界点为10.12 fL，其灵敏度、特异度、AUC、阴性预测值、阳性预测值以及准确度分别为89.2%、87.8%、0.882、84.6%、91.5%、88.4%。结论：MPV对rtPA溶栓治疗急性缺血性脑卒中有一定的预测价值，为短期溶栓治疗预后的独立危险因素。
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关键词:
- 脑缺血 /
- 静脉溶栓 /
- 重组组织型纤溶酶原激活剂 /
- 平均血小板容积
Abstract: Objective: To investigate the predict value of the mean platelet volume(MPV) on prognosis of the ischemic stroke patients treated with recombinant tissue type plasminogen activator(rtPA) intravenous thrombolysis.Methods: The prognosis of patients treated with rtPA thrombolysis was evaluated using the modified Rankin scale(MRS).The patients were divided into the good prognosis group and poor prognosis group,and the influence of MPV on the prognosis of patients treated with rtPA thrombolysis was discussed.Results: The differences of the age,incidence rate of atrial fibrillation,aspirin use history,systolic blood pressure,diastolic blood pressure,NIHSS score,INR,blood glucose,total cholesterol,high-density lipoprotein cholesterol,low density lipoprotein cholesterol,thrombocytocrit,MPV,platelet distribution width and CISS typing between two groups were statistically significant(P<0.05 to P<0.01).Logistic regression analysis showed that the age,previous aspirin use history,baseline NIHSS score,blood glucose,LDL-C,MPV,PDW,cardiogenic stroke and perforating artery disease were the independent influencing factors of the prognosis of rtPA thrombolytic therapy(P<0.05 to P<0.01).Linear regression analysis showed that the MPV was negatively correlated with MRS score(P<0.05).The best clinic point of MPV in the diagnosis of the prognosis of rtPA thrombolytic therapy was 10.12 fL,and the sensitivity,specificity,AUC,negative predictive value,positive predictive value and accuracy of MPV were 89.2%,87.8%,0.882,84.6%,91.5% and 88.4%,respectively.Conclusions: MPV has a certain predictive value in rtPA thrombolysis treating acute ischemic stroke,which is an independent risk factor of short-term thrombolysis treatment. -
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