住院期间血小板平均体积变化与老年重症肺炎预后的相关性分析

doi:10.3969/j.issn.1003-9198.2021.04.014

摘要/Abstract

摘要： 目的探讨住院期间血小板平均体积(MPV)变化与老年重症肺炎(severe pneumonia, SP)预后的关系。方法回顾性分析本院于2017年1月至2019年12月收治的158例老年SP病人的临床资料,根据病人出院时MPV与入院时MPV的差值分为MPV未增高组(ΔMPV＜0.6 fL)和MPV增高组(ΔMPV≥0.6 fL),比较2组间临床特征、转重症医学科(ICU)、机械通气治疗、住院时间及死亡率;根据出院时病人是否存活,将病人分为存活组和死亡组,采用多因素Logistic回归分析老年SP病人院内死亡的相关危险因素。结果 MPV增高者占17.72％(28/158),MPV未增高组与增高组年龄、合并肾功能不全及脑血管疾病、社区获得性肺炎评分(CURB-65)、肺炎严重程度评分(PSI)、机械通气治疗、院内死亡率差异均有统计学意义(P＜0.05);多因素Logistic回归分析显示,住院期间ΔMPV≥0.6 fL,PSI评分、CURB-65评分高及合并脑血管疾病是老年SP病人死亡的高危因素(P＜0.05)。结论住院期间ΔMPV与老年SP病人CURB-65评分、PSI评分及院内死亡率密切相关,MPV增高可能是老年SP病人住院期间预后不良的高危因素。

关键词: 血小板平均体积, 重症肺炎, 老年人, 预后

Abstract: Objective To explore the correlation between the change in mean platelet volume(MPV)during hospitalization and prognosis of the elderly patients with severe pneumonia(SP). Methods The clinical data of 158 elderly patients with SP who were admitted to our hospital from January 2017 to December 2019 were retrospectively analyzed. The patients were divided into group A with ΔMPV(MPV on discharge minus MPV at admission)<0. 6 fL and group B with ΔMPV≥0. 6 fL. The clinical characteristics, the rate of transfering to the intensive care unit, the rate of receiving mechanical ventilation, duration of hospital stay and death rate were compared between groups A and group B. The risk factors of in-hospital death in the elderly patients with SP were analyzed by multivariate Logistic regression analysis. Results There were statistically difference between groups A and group B in age, incidence rate of renal dysfunction, and cerebrovascular disorder, CURB-65 score, PSI score, rate of receiving mechanical ventilation therapy and in-hospital mortality(P＜0. 05). Multivariate Logistic regression analysis showed that ΔMPV≥0. 6 fL, high CURB-65 score, high PSI score, cerebrovascular disorder were risk factors for recent poor prognosis in the elderly patients with SP (P＜0. 05). Conclusions ΔMPV during hospitalization is closely related to CURB-65 score, PSI score and in-hospital mortality in the elderly patients with SP, which is an probable high-risk factor for recent poor prognosis of the elderly patients with SP.

Key words: mean platelet volume, severe pneumonia, aged, prognosis

中图分类号:

R 563.1

谭云辉, 冯丽. 住院期间血小板平均体积变化与老年重症肺炎预后的相关性分析[J]. 实用老年医学, 2021, 35(4): 374-377.

TAN Yun-hui, FENG Li. Relationship of the change in mean platelet volume with prognosis of elderly patients with severe pneumonia during hospitalization[J]. Practical Geriatrics, 2021, 35(4): 374-377.

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