单核细胞–大血小板比率对AECOPD合并PE患者诊断价值

Diagnostic Value of Monocyte-Large Platelet Ratio in Patients with AECOPD and PE

摘要: 目的：探究单核细胞–大血小板比率(Monocyte to large platelet ratio, MLPR)对于慢性阻塞性肺疾病急性加重(Acute exacerbation of chronic obstructive pulmonary disease, AECOPD)患者是否合并分肺栓塞(Pulmonary embolism, PE)。方法：回顾性分析2010年1月至2019年6月在青岛大学附属医院诊治的已行CTPA检查疑诊PE的AECOPD患者，比较两组患者MLPR水平，并绘制受试者操作特性(Receiver operating characteristics, ROC)曲线，确定MLPR的临界值。结果：该研究纳入AECOPD合并PE组患者232人，单纯AECOPD患者470人，AECOPD合并PE组患者MLPR (OR = 68.678)高于单纯AECOPD组，且有统计学意义(P < 0.05)，MLPR的AUC为0.855 (95% CI 0.827~0.883)，并当MLPR取值为>1.04%时，对AECOPD合并PE有最佳诊断价值，此时的最佳诊断灵敏度为94.8%，诊断特异度为75.7%。结论：MLPR在AECOPD合并PE患者中有重要的诊断价值，其兼具较高的灵敏度及特异度，具有很高的临床应用价值。

Abstract: Objective: To investigate whether monocyte to large platelet ratio (MLPR) is associated with pul-monary embolism (PE) in patients with acute exacerbation of chronic obstructive pulmonary dis-ease (AECOPD). Methods: A retrospective analysis was performed on patients with AECOPD who had undergone CTPA examination and suspected PE in the Affiliated Hospital of Qingdao University from January 2010 to June 2019 to compare the MLPR levels of the two groups of patients and plot the receiver operating characteristics (Receiver operating characteristics, ROC) curve to determine the critical value of MLPR. Results: This study included 232 patients in the AECOPD combined PE group and 470 patients in the AECOPD alone group. The MLPR (OR = 68.678) of the patients in the AECOPD combined PE group was higher than that in the AECOPD group alone, and was statistically significant (P < 0.05). It is 0.855 (95% CI 0.827 - 0.883), and when the MLPR value is >1.04%, it has the best diagnostic value for AECOPD combined with PE. At this time, the best diagnostic sensitivity is 94.8% and the diagnostic specificity is 75.7%. Conclusion: MLPR has important diagnostic value in patients with AECOPD and PE. It has high sensitivity and specificity, and has high clinical application value.