目的 探讨平均血小板体积(MPV)与血液透析患者急性缺血性脑血管病事件(AICE)的相关性,评估MPV对AICE的预测价值。方法 收集2015-01至2021-12北京朝阳医院肾内科透析室维持性血液透析(MHD)患者为研究对象(n=232),根据是否发生AICE分为AICE组(n=77)与非AICE组(n=155),比较两组间MPV及临床特征等差异。单因素及多因素Cox回归分析AICE发生的独立危险因素,绘制受试者工作特征曲线(ROC)评估MPV对血液透析患者AICE发生风险的预测价值。结果 与非AICE组比较,AICE组患者MPV[10.7(10.3,11.3)fl vs. 10.3(9.7,10.8)fl,Z=3.8938,P<0.001]明显升高,年龄、吸烟、CAD病史、1周平均超滤脱水量、总胆固醇、低密度脂蛋白胆固醇、三酰甘油均高于非AICE组,白蛋白低于AICE组。多因素Cox回归显示,矫正后AIS病史、吸烟、超滤脱水量增加、白蛋白降低、MPV增高[HR 1.601(1.219,2.102);P< 0.001]是AICE发生的独立危险因素。MPV预测血液透析患者AICE的ROC曲线下面积为0.824, 特异度为0.883,敏感度为0.716。结论 MPV是维持性血液透析患者AICE发生的独立危险因素,对AICE发生风险具有良好的预测价值。
Abstract
Objective To investigate the correlation between mean platelet volume (MPV) and acute ischaemic cerebrovascular events (AICE) in haemodialysis (MHD)patients, and to evaluate the predictive value of MPV for AICE events. Methods Patients with maintenance MHD in the Nephrology Department of Beijing Chaoyang Hospital from January 2015 to December 2021 were collected as study subjects (n=232), and according to the occurrence of acute ischaemic cerebrovascular disease events they were divided into the AICE group (n=77) and non-AICE group (n=155). Differences in MPV and clinical features were compared between the two groups. Univariate and multivariate Cox regression was used to analyze the independent risk factors for AICE, and receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of MPV for the risk of AICE in MHD patients. Results Compared with the non-AICE group, patients in AICE group had significantly higher MPV[10.7 (10.3,11.3) fl vs. 10.3 (9.7,10.8) fl, Z=3.8938, P<0.001]. Age, smoking, history of CAD, 1-week mean ultrafiltration dehydrate volume, total cholesterol, LDL cholesterol, and triglyceride were all higher than those in non-AICE group, while albumin was lower than that in AICE group. Multivariate Cox regression showed that AIS history after correction, smoking, increased water removal by ultra-filtration, decreased albumin, and increased MPV [HR 1.601 (1.219, 2.102); P< 0.001] were independent risk factors for AICE. The AUC of the ROC curve on MPV was 0.824, the specificity was 0.883 and the sensitivity was 0.716. Conclusions MPV is an independent risk factor for AICE in MHD patients and has good predictive value for AICE.
关键词
平均血小板体积 /
急性缺血性脑血管病事件 /
血液透析
Key words
mean platelet volume /
acute ischaemic cerebrovascular event /
hemodialysis
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