| Sepsis is a common critical illness in intensive care unit(ICU)with high mortality.Therefore,it is of great clinical significance to correctly judge the prognosis.At present,there are many studies on the biomarkers of prognosis in sepsis,but the clinical methods of prognosis are still unclear.Platelets are often thought to be associated with the occurrence,development and prognosis of sepsis.Platelet count(PC)and mean platelet volume(MPV)often change in sepsis,but there are many factors affecting the above indicators.The sensitivity and specificity of these indicators for predicting the prognosis of sepsis are relatively low,while the ratio of mean platelet volume to platelet count(MPV/PC)as a combined parameter may have better specificity in reflecting the number of platelets and the shape of platelets.Heterosexuality and sensitivity.Therefore,this study explores whether MPV/PC has a higher value in early evaluation of the prognosis of patients with sepsis,and compares the correlation between MPV,PC,MPV/PC ratio and the concentration of serum fibrinogen(FBG),the core molecule of platelet action mechanism,in sepsis.Objective:To investigate the sensitivity and specificity of PC,MPV and MPV/PC in evaluating the prognosis of sepsis patients,and to compare the correlation with the previously reported FBG method in predicting the prognosis of sepsis patients.It provides a simple and feasible clinical evaluation method for the prognosis of sepsis patients.Method:This study retrospectively analyzed the clinical data of sepsis patients admitted to the Department of severe Medicine,the first Hospital of Jilin University from January 1,2016 to January 1,2018.according to the prognosis of the patients,they were divided into death group and survival group.The ratio of PC,MPV,MPV/PC and the concentration of FBG were compared between the two groups at the time of diagnosis of sepsis,and the relationship between the above hematological parameters and the prognosis of sepsis and the correlation between them were clarified.The sensitivity and specificity of PC,MPV and MPV/PC in evaluating the prognosis of sepsis patients were evaluated by(ROC)curve.The results were applied to the clinical data to judge the mortality of the patients with or without MPV/PC elevation.Results:1.103 patients with sepsis were included in this study.There were 88 cases in survival group and 15 cases in death group.The mortality rate was 14.6%.There were 55 males and 48 females.The average age was 64.03±16.372(20-93 years old).2.APACHE? score in death group was 26(15,34),APACHE?score in survival group was 16(8,29),and APACHE? score in death group was significantly higher than that in survival group(p<0.05).3.In the diagnosis of sepsis,PC,MPV and MPV/PC in survival group were 152.92±73.50,11.69±1.24,0.10±0.05,respectively.PC,MPV and MPV/PC in the death group were 102.27±55.15,13.23±2.05,0.16±0.06,respectively.there was significant difference between the two groups.There was no statistical significance between the two groups of FBG.4.Spearman correlation analysis was used to calculate the correlation among PC,MPV,MPV/PC and FBG.The results showed that MPV/PC was positively correlated with MPV and negatively correlated with PC;MPV was negatively correlated with PC;FBG was not correlated with MPV,PC and MPV/PC.5.the area under the curves of PC,MPV and MPV/PC were 0.690,0.734 and 0.804 respectively by(ROC)analysis of the characteristic curves of the subjects in the death group.The results showed that the ability of MPV/PC as a combined index to predict the mortality rate of sepsis was better than that of PC and MPV.When MPV/PC>0.12,the sensitivity and specificity were 84.62%and 71.79%,respectively.the selection of MPV/PC=0.12 as the cutoff value could be used to judge the prognosis of sepsis patients.6.Logistic regression analysis showed that age,APACHE? score,PC,MPV,MPV/PC were lisk factors for sepsis.Age,APACHE? score,MPV and MPV/PC were independent risk factors affecting the prognosis of sepsis patients.7.There were 40 cases in sepsis MPV/PC elevation group,11 cases died,the mortality rate was 27.5%;63 cases in sepsis MPV/PC elevation group,4 cases died,the mortality rate was 6.3%,the difference was statistically significant(P<0.05).Conclusion:In sepsis patients,PC decreased,MPV increased and MPV/PC increased.The above changes were more significant in the death group of sepsis.There was no difference in FBG between the two groups.In sepsis patients,MPV/PC was positively correlated with MPV and negatively correlated with PC;MPV was negatively correlated with PC;FBG was not correlated with MPV,PC,MPV/PC.Age,APACHE? score,MPV,PC,MPV/PC are independent risk factors affecting the prognosis of sepsis patients.PC,MPV,MPV/PC have certain clinical value in predicting the fatality rate of sepsis,among which MPV/PC has better predictive ability.When MPV/PC>0.12,the sensitivity and specificity for predicting mortality were 84.62%and 71.79%,respectively.The mortality of sepsis patients with elevated MPV/PC was higher(27.5%)and that of sepsis patients without elevated MPV/PC was 6.3%. |
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