血清MPV、PDW、P-LCR与颈动脉斑块的相关性分析

Correlation Analysis between Serum Platelet Distribution width, Mean Platelet Volume, Platelet-Larger Cell Ratio and Carotid Atherosclerotic Plaque

摘要: 目的：探讨颈动脉粥样硬化(CAS)患者血小板体积参数与斑块面积之间的相关性。方法：收集2024年1月至2024年10月于广西中医药大学附属瑞康医院住院治疗的CAS斑块患者的临床资料，包括性别、年龄、平均血压、血小板体积分布宽度(PDW)、平均血小板体积(MPV)、大血小板比率(P-LCR)及颈部血管彩超等资料。依据血小板体积参数，将指标偏低的研究对象设定为观察组，正常的设定为对照组，比较上述两组数据，通过多因素逐步Logistic回归模型分析CAS患者发生斑块的危险因素；运用Pearson法分析PDW、MPV、P-LCR与颈动脉斑块之间的相关性；绘制受试者工作特征(ROC)曲线，分析PDW、MPV、P-LCR诊断CAS斑块的效能。结果：观察组的PDW、MPV及P-LCR均低于对照组，斑块面积以及斑块负荷积分差异具有统计学意义(P < 0.05)。多因素逐步Logistic回归分析：PDW：[O^{^}R = 2.510 (95% CI: 1.476, 1.268)]、P-LCR [O^{^}R = 1.418 (95% CI: 446, 0.581)]是CAS患者发生斑块的危险因素(P < 0.05)。Pearson相关性分析结果显示:PDW、MPV、P-LCR与颈动脉斑块严重程度呈正相关性(r = 0.233, 0.259, 0.264, P < 0.05)；ROC曲线下AUC分别为0.776 (95% CI: 0.708, 0.843)、0.755 (95% CI: 0.688, 0.821)、0.753 (95% CI: 0.685, 0.822)。结论：MPV、PDW、P-LCR血小板体积参数对CAS斑块具备较高的预测价值。

Abstract: Objective: To investigate the correlation between platelet volume parameters and plaque area in patients with carotid atherosclerosis (CAS). Methods: The clinical data of patients with CAS plaque who were hospitalized in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from January 2024 to October 2024 were collected, including gender, age, mean blood pressure, platelet distribution width (PDW), mean platelet volume (MPV), large platelet ratio (P-LCR) and cervical vascular color Doppler ultrasound. According to the platelet volume parameters, the subjects with low index were set as the observation group, and those with normal index were set as the control group. The data of the above two groups were compared, and the risk factors of plaque in CAS patients were analyzed by multivariate stepwise Logistic regression model. Pearson correlation analysis was used to analyze the correlation between PDW, MPV, P-LCR and carotid plaque. The receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of PDW, MPV and P-LCR in the diagnosis of CAS plaque. Results: The PDW, MPV and P-LCR of the observation group were lower than those of the control group, and the differences in plaque area and plaque burden score were statistically significant (P < 0.05). Multivariate stepwise Logistic regression analysis showed that PDW: [O^{^}R = 2.510 (95% CI: 1.476, 1.268)], P-LCR [O^{^}R = 1.418 (95% CI: 446, 0.581)] was a risk factor for CAS plaque patients (P < 0.05). Pearson correlation analysis showed that PDW, MPV, P-LCR were positively correlated with the severity of carotid plaque (r = 0.233, 0.259, 0.264, P < 0.05). The AUC under the ROC curve was 0.776 (95% CI: 0.708, 0.843), 0.755 (95% CI: 0.688, 0.821) and 0.753 (95% CI: 0.685, 0.822), respectively. Conclusions: MPV, PDW and P-LCR platelet volume parameters have high predictive value for CAS plaque.