血小板平均容积在老年房颤患者栓塞中的风险评估价值

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[目的]探讨血小板平均容积(MPV)在老年房颤患者栓塞中的风险评估价值.[方法]选取单纯房颤39例(阴性组),房颤合并血管病变或栓塞48例(阳性组),检测并比较两组MPV值,并分析其在老年房颤患者栓塞中的风险评估价值.[结果]阳性组CHA2DS2-VASc评分为(3.77±1.28)分,明显高于阴性组(2.38±1.18)分,其差异有统计学意义(t=5.205,P=0.000);阳性组去除血管病变(1分)和中风/TIA/血栓史(2分)两项得分因素后,CHA2DS2-VASc评分为(2.98±1.25)分,明显高于阴性组(2.38±1.18)分,其差异仍然有统计学意义(t=2.263,P=0.026).阳性组MPV平均值为(11.58±1.24) fL,明显高于阴性组(10.39±1.07)fL,其差异有统计学意义(t=4.714,P=0.000).ROC曲线下面积达0.773,具有较高的诊断价值,根据曲线的坐标显示当分界值MPV选择定为11.1/11.2 fL时,可获得最大约登指数0.466,此时灵敏度为64.6%,特异度为82.1%.[结论]MPV是一种评估老年房颤患者栓塞风险的有效指标,具有较高的灵敏度和特异度,值得临床推广使用.“,”[Objective] To study the application values of mean platelet volume (MPV) and embolism risk assessment in elderly patients with atrial fibrillation.[Methods]Simple atrial fibrillation (39 cases,negative group) and atrial fibrillation combined with vascular lesions or embolization (48 cases,positive group) were collected.General clinical data of patients and routine blood MPV values of the two groups were compared and analyzed.[Results]The CHA2 DS2-VASc method was used for the evaluation,i.e.congestive heart failure,hypertension,age ≥75 (doubled),diabetes,stroke (doubled),vascular disease,age 65~74,and sex (female).The CHA2DS2-VASc score(2.38± 1.18) of the negative group was lower than that of the positive group (3.77±1.28),and the difference was statistically significant (P <0.05).Even after 3 points (1 for vascular disease and 2 for stroke/TIA) were subtracted from the score of the positive group,its CHA2DS2-VASc score (2.98± 1.25)was still higher than that of the negative group (P <0.05).The MPV value in the negative group (10.39 ± 1.07)fL was lower than that in the positive group (11.58 ± 1.24)fL.The difference in the two groups was statistically significant (P <0.05).The area under the ROC curve was 0.773,which predicted high-risk embolism in elderly patients with atrial fibrillation.According to the ROC curve,the cutoff value of MPV was set at 11.1/11.2 fL.Then,the maximum index approached 0.446 with its sensitivity and specificity rate being 64.6 % and 82.1%,respectively.[Conclusion] MPV is one of the effective indicators to assess the risk of embolism in elderly patients with atrial fibrillation.It has high sensitivity and specificity,and it is worthy application in the clinic.
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