【摘要】 目的探讨血小板平均容积(MPV)与血小板计数(PLT)与老年急性主动脉夹层患者住院病死率的关系。方法选择2010年1月1日~2016年1月1日天津市第一中心医院心脏科住院的主动脉夹层患者101例,根据住院期间是否存活分为存活组75例和死亡组26例;又根据MPV/PLT比值分为1分位组25例(MPV/PLT≤0.046),2分位组25例(0.046<MPV/PLT≤0.056),3分位组26例(0.056<MPV/PLT≤0.069),4分位组25例(MPV/PLT>0.069)。采集患者住院时基线资料及D-二聚体等,观察患者住院并发症及病死率。结果死亡组A型夹层、D-二聚体和MPV/PLT比值明显高于存活组[88.5%vs 38.7%,P=0.000;6374μg/L vs 2049μg/L,P=0.000;0.069±0.024 vs 0.056±0.018,P=0.003],收缩压和PLT明显低于存活组[(127.9±34.2)mm Hg(1mm Hg=0.133kPa)vs(158.2±32.1)mm Hg,P=0.000;(175.5±64.2)×109/L vs(205.4±61.9)×109/L,P=0.039]。不同分位组住院病死率比较,差异有统计学意义(P=0.033),4分位组住院病死率明显高于1、2和3分位组(48.0%vs 16.0%,20.0%,19.2%,P<0.05)。结论老年急性主动脉夹层患者MPV/PLT比值升高预示更高的病死率。更多还原

【Abstract】 Objective To study the relationship of mean platelet volume(MPV)and platelet count ratio(PLT)with in-hospital mortality in elderly acute aortic dissection(AAD)patients.Methods One hundred and one AAD patients admitted to our hospital were divided into survival group(n=75)and death group(n=26)and further divided into MPV/PLT≤0.046(Q1)group(n=25),0.046<MPV/PLT≤0.056(Q2)group(n=25),0.056<MPV/PLT≤0.069(Q3)group(n=26),and MPV/PLT>0.069(Q4)group(n=25)according to the MPV/PLT ratio.Their baseline data were recorded and serum D-dimer level was measured on admission,complications and mortality after admission were recorded.Results The incidence of A-type dissection,serum D-dimer level and MPV/PLT ratio were significantly higher in death group than in survival group(88.5%vs38.7%,P=0.000;6374μg/L vs 2049μg/L,P=0.000;0.069±0.024 vs0.056±0.018,P=0.003).The SBP and platelet count were significantly lower in death group than in survival group(127.9±34.2 mm Hg vs 158.2±32.1 mm Hg,P=0.000;175.5±64.2×109/L vs 205.4±61.9×109/L,P=0.039).The in-hospital mortality was significantly different in different MPV/PLT ratio groups(P=0.033)and was significantly higher in Q4 group than in Q1,Q2 and Q3 groups(48.0%vs 16.0%,20.0%,19.2%,P<0.05).Conclusion Elevated MPV/PLT ratio indicates a higher in-hospital mortality in elderly AAD patients.更多还原