摘要
目的 探讨凝血功能指标联合平均血小板体积与血小板计数比值对急性脑梗死(ACI)的诊断价值.方法 95例ACI患者按照疾病严重程度分为轻度39例、中度37例及重度19例,比较不同程度ACI患者入院时的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D二聚体(D-Dimer)、纤维蛋白溶解产物(FDP)]和平均血小板体积与血小板计数比值;采用ROC曲线下面积(AUC)评估凝血功能指标、平均血小板体积与血小板计数比值单项或联合检测对ACI严重程度的诊断价值;采用Pearson相关系数(r)分析各项检测指标与ACI的相关性.结果 轻度组患者PT、APTT及TT长于中度组和重度组,FIB、D-Dimer、FDP及平均血小板体积与血小板计数比值低于中度组和重度组,差异有统计学意义(P＜0.05);ROC曲线结果显示,凝血功能指标、平均血小板体积与血小板计数比值联合检测诊断ACI的AUC为0.943,高于其他单项检测的AUC;相关性分析显示,ACI患者PT、APTT、FIB、TT、D-Dimer、FDP及平均血小板体积与血小板计数比值均存在一定的相关性(P＜0.05).结论 不同严重程度ACI患者的凝血功能指标及平均血小板体积与血小板计数比值存在明显差异,凝血功能指标及平均血小板体积与血小板计数比值对ACI诊断具有一定价值,联合检测诊断价值更高.
Abstract
Objective To explore the diagnostic value of coagulation function combined with mean platelet volume-to-platelet count ratio(MPV/PC)for acute cerebral infarction(ACI).Methods A total of 95 patients with ACI were divided based on the severity of the disease as mild group(39 cases),moderate group(37 cases)and severe group(19 cases).Coagulation function indicators were compared among the patients with different ACI severity at admission,including prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-dimer(D-Dimer),fibrinogen degradation products(FDP)and MPV/PC.Area under ROC curve(AUC)was used to evaluate the value of coagulation function indicators,MPV/PC alone or their combination in diagnosing the severity of ACI.Pearson correlation coefficient(r)was used to analyze the association of various detection indicators with ACI.Results PT,APTT,and TT in mild group were longer than those in moderate and severe groups,while FIB,D-Dimer,FDP,and MPV/PC were lower than those in moderate and severe groups(P＜0.05).ROC curve results showed that the AUC of coagulation function indicators and MPV/PC for diagnosing ACI was 0.943,which was higher than the AUC of other individual tests.Correlation analysis showed that there were certain correlations between PT,APTT,FIB,TT,D-Dimer,FDP,and MPV/PC in the patients with ACI(P＜0.05).Conclusion There are significant differences in coagulation function indicators and MPV/PC among the patients with different severity of ACI.Coagulation function indicators and MPV/PC have certain values in diagnosing ACI.The combined detection has a high diagnostic value.
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