摘要
目的 分析平均血小板体积/淋巴细胞比值(mean platelet volume-to-lymphocyte ratio, MPVLR)对颅脑损伤患儿预后的评估价值。方法 选取2020-06/2022-06月在作者医院确诊并进行治疗的96例颅脑损伤患儿作为研究对象,所有纳入对象入院后均检测平均血小板体积(mean platelet volume, MPV)、淋巴细胞水平,并计算MPVLR。根据入院时格拉斯哥昏迷评分(Glasgow coma score, GCS)分为中度组(n=52,GCS评分9~12分)、重度组(n=44,GCS评分3~8分);同时根据患儿28天的预后情况分为预后良好组(n=56)和预后不良组(n=40)。通过受试者工作特征(receiver operatoring characteristic, ROC)曲线和曲线下面积(area under the curve, AUC)评估MPVLR对颅脑损伤患儿预后的预测价值,采用多因素Logistic回归分析探讨影响颅脑损伤患儿预后的相关因素。结果 重度组患儿MPVLR明显高于中度组,组间比较差异具有统计学意义(P<0.05);预后不良组患儿MPVLR明显高于预后良好组,组间比较差异具有统计学意义(P<0.05)。MPVLR预测颅脑损伤患儿预后的AUC为0.866(95%CI:0.791~0.921),最佳截断值为7.69,灵敏度与特异度为78.69%和89.61%。多因素Logistic回归分析显示,MPVLR>7.59(OR=3.78,95%CI:1.99~7.19)、入院时GCS评分≤8分(OR=3.36,95%CI:1.92~5.92)、血乳酸(lactic acid, LAC)>2.55 mmol/L(OR=3.32,95%CI:1.98~5.58)均是影响颅脑损伤患儿预后的危险因素。结论 MPVLR与颅脑损伤患儿的病情程度以及预后密切相关,有望作为预测颅脑损伤患儿预后的有效生物标志物。
Objective To explore the prognostic value of mean platelet volume-to-lymphocyte ratio(MPVLR) in children with craniocerebral injury. Methods A total of 96 children with craniocerebral injury diagnosed and treated in author′s hospital from June 2020 to June 2022 were selected as the study subjects. The mean platelet volume(MPV) and lymphocyte levels of all the enrolled subjects were measured after admission, and the MPVLR ratio was calculated. The patients were divided into moderate group(n=52, GCS score 9-12 points) and severe group(n=44, GCS score 3-8 points) according to Glasgow coma score(GCS) at admission, at the same time, the patients were divided into good prognosis group(n=56) and poor prognosis group(n=40) according to their 28 days′ prognosis. The predictive value of MPVLR on the prognosis of children with craniocerebral injury was evaluated by receiver operatoring characteristic(ROC) curve and area under the curve(AUC), and the related factors affecting the prognosis of children with craniocerebral injury were analyzed by multivariate Logistic regression. Results The MPVLR in severe group was significantly higher than that in moderate group, and the difference was statistically significant(P<0.05);the MPVLR of children with poor prognosis was significantly higher than that of children with good prognosis, and the difference was statistically significant(P<0.05). The AUC of MPVLR to predict the prognosis of children with craniocerebral injury was 0.866(95%CI: 0.791-0.921), the best cut-off value was 7.69, and the sensitivity and specificity were 78.69% and 89.61%. Multivariate Logistic regression analysis showed that MPVLR>7.59(OR=3.78, 95%CI: 1.99-7.19), GCS score≤8 at admission(OR=3.36, 95%CI: 1.92-5.92), lactic acid(LAC) >2.55 mmol/L(OR=3.32, 95%CI: 1.98-5.58) were all risk factors affecting the prognosis of children with craniocerebral injury. Conclusion MPVLR is closely related to the severity and prognosis of children with craniocerebral injury, which may be used as an effective biomarker to predict the prognosis of children with craniocerebral injury.
作者
周雯
李娜
卞兰峥
刘一鸣
ZHOU Wen;LI Na;BIAN Lanzheng;LIU Yiming(Department of Neurosurgery,Affiliated Children's Hospital of Nanjing Medical University,Nanjing Jiangsu 210023,China)
出处
《联勤军事医学》
CAS
2023年第9期757-760,共4页
Military Medicine of Joint Logistics
基金
南京市医科大学科技发展项目(NMUB2018095)。
关键词
平均血小板体积/淋巴细胞比值
颅脑损伤
儿童
预后
Mean platelet volume-to-lymphocyte ratio
Craniocerebral injury
Children
Prognosis
