Changes And Clinical Significance Of Platelet Distribution Width And Mean Platelet Volume In Acute Pulmonary Embolism

Objective: Evaluate the changes and clinical significance of platelet distribution width(PDW)and mean platelet volume(MPV)in acute pulmonary embolism(APE)patients.Methods: A retrospective analysis of diagnosed APE patients was conducted in the Respiratory and Critical Care Medical Unit of Shengjing Hospital,China Medical University from January 1,2017 to April 30,2018.APE group(61 patients)were patients who were admitted to the hospital with a confirmed diagnosis of APE,and were further divided into intermediate-risk subgroup(29 cases)and low-risk subgroup(32cases).59 healthy people enrolled in the control group.Baseline characteristics(including gender,age,length of hospital stay,etc.)and test results(PDW,MPV,etc.)of the two groups and the two subgroups were compared.Spearman correlation test was used to express the correlation of PDW and MPV level with APE risk stratification.Clinical value of PDW,MPV and PDW combined MPV for APE diagnosis and risk stratification were compared through analysis of the receiver operating characteristic curve.Results : 1.APE group and control group: No significant differences in gender composition,age,mean arterial pressure in admission time,body temperature,respiratory rate per minute,hemoglobin,and platelet in the two groups(all P > 0.05).The PDW(Z=-3.775,P<0.001)and MPV(Z=-2.230,P=0.026)of APE group is higher than that of healthy control group.2.PDW combined MPV(sensitivity: 68.9%,specificity:73.7%)is better than PDW and PMV in APE diagnosis,with the area under the ROC curve(AUC)=0.741(95% CI: 0.653-0.830).3.PDW(r=0.327,P=0.005)and MPV(r=0.245,P=0.029)of APE patients were correlated with APE risk stratification positively.PDW(r=-0.280,P=0.014)in APE patients were negatively correlated with platelet level.4.Intermediate-risk subgroup and low-risk subgroup: No significant difference in gender composition,age,height,weight,mean arterial pressure at admission,body temperature,respiratory rate/min,blood oxygen saturation,andhospital-stay time in the two subgroups(all P>0.05).5.Intermediate-risk subgroup and low-risk subgroup: PDW(Z=-2.686,P=0.007)and MPV(Z=-2.270,P=0.023)in the intermediate-risk subgroup is higher than low-risk subgroup.Two subgroups' platelet(Z=-1.827,P=0.068)and hemoglobin(Z=-0.116,P=0.908)is of no statistical difference.The right ventricular end-diastolic diameter(Z=-3.938,P<0.001),right inside diameter /left inside diameter(Z=-4.453,P<0.001),inner diameter of pulmonary artery(Z=-2.669,P=0.008)in the intermediate-risk subgroup are higher than low-risk subgroup.The left ventricle end-diastolic diameter of the intermediate-risk subgroup is lower than low-risk subgroup(Z=-3.056,P=0.002).6.PDW combined MPV(sensitivity: 75.9%,specificity:75.0%)is better than PDW and PMV in APE risk stratification,with AUC=0.742(95%CI: 0.615-0.869).Conclusion: PDW and MPV of APE patients increased,and related to risk stratification of APE.PDW combined MPV is better than PDW or MPV in recognition of APE patients and risk stratification.