The role of neutrophil-lymphocyte ratio, and mean platelet volume in detecting patients with acute venous thromboembolism
The role of neutrophil-lymphocyte ratio, and mean platelet volume in detecting patients with acute venous thromboembolism
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DOI：
10.1002/jcla.23010
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发表时间：
2019-09-11
影响因子：
2.7
通讯作者：
Khamisy-farah, Rola
中科院分区：
文献类型：
--
作者：
Farah, Raymond;Nseir, William;Khamisy-farah, Rola
背景急性静脉血栓栓塞症（VTE）是指四肢深静脉血栓形成（DVT）或肺栓塞（PE），或两者兼而有之。可靠的成像并不总是可用的，因此非常需要血清学诊断或生物标志物。目的探讨血小板-淋巴细胞比率（NLR）、血小板-淋巴细胞比率（PLR）和平均血小板体积（MPV）在急性静脉血栓栓塞（VTE）诊断中的作用。方法对我院327例急性VTE患者的临床资料进行分析。其中确诊为静脉血栓栓塞症的272例患者作为对照组，55例非静脉血栓栓塞症患者作为对照组。入院时测定全血细胞计数（CBC）、NLR、MPV和PLR。结果VTE患者年龄大于对照组（分别为62 ± 18.9岁和55.4 ± 15.1岁，P = 0.03）。两组均以女性为主。在研究组中，178/272（66%）例发生DVT，84/272（31%）例发生肺栓塞（PE），其余均发生DVT和PE。与对照组相比，急性VTE患者的NLR、MPV和PLR显著升高（分别为P <0.001，P = 0.008，P = 0.014）。对NLR和MPV预测急性VTE的ROC曲线进行分析，发现NLR的截断值为5.3，曲线下面积为0.67（0.60-0.75），P <0.001，敏感性为69%，特异性为57%。MPV的临界值为8.6，曲线下面积为（0.61 [0.53-0.68]，P = 0.014，敏感性为52%，特异性为67%。多变量logistic回归模型发现NLR（OR 1.2，95%CI [1.01-1.4]，P = 0.041）和MPV（OR 1.5，95%CI [1.07-2.12]，P = 0.5）与急性VTE相关。结论中性粒细胞/淋巴细胞比值和MPV可作为早期诊断急性VTE的有益指标。
Background Acute venous thromboembolism (VTE) refers to deep venous thrombosis (DVT) of the extremities or pulmonary embolism (PE), or to both. Reliable imaging is not always available making a serologic diagnosis, or biomarker, highly desirable. Objective This study aimed to examine the role of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) in detection patients with acute VTE. Methods A total of 327 patients with initial diagnosis of acute VTE who were admitted to Ziv hospital were evaluated. Of them, 272 patients with definitive diagnosis of VTE, and 55 patients without VTE were used as control group. Complete blood count (CBC), measurements of NLR, MPV, and PLR were determined at admission. Results Patients with VTE were older than controls (62 +/- 18.9 vs 55.4 +/- 15.1 years, respectively, P = .03). Female gender was predominant in the two groups. In the study group, 178/272 (66%) had DVT, 84/272 (31%) had pulmonary embolism (PE), and the rest had DVT and PE. NLR, MPV, and PLR were found to be significantly elevated in acute VTE compared to control (P < .001, P = .008, P = .014, respectively). A ROC curve analysis of NLR and MPV for predicting acute VTE was performed which found a cut-off value of 5.3 for NLR, an area under curve of (0.67 (0.60-0.75), P < .001, with a sensitivity of 69% and specificity of 57%. and a cut-off value of 8.6 for MPV, an area under curve of (0.61 [0.53-0.68], P = .014, with a sensitivity of 52% and specificity of 67%. Multivariate logistic regression model found that NLR (OR 1.2, 95% CI [1.01-1.4], P = .041) and MPV (OR 1.5, 95%CI [1.07-2.12], P = .5) were associated with acute VTE. Conclusions Neutrophil-lymphocyte ratio and MPV could be beneficial predictors for the early detection of potential acute VTE.