Diagnostic Value Of Red Blood Cell Distribution Width(RDW) And Mean Platelet Volume(MPV) In Acute Pulmonary Embolism(APE)

Objective:To investigate diagnostic value of red blood cell distribution width(RDW)and mean platelet volume(MPV)in APE and provide clues for early diagnosis of APE.Method:APE group was consist of 110 APE patients who hospitalized in the First Affiliated Hospital of Nanchang University from June 2015 to December 2019.All patients follow related criterion of diagnosis strictly.Control group was consist of 110healthy people who had physical examination during the same period.All people did not have any disease or symptom.Collected detailed information and some laboratory data,including platelet counts,neutrophil count,RDW,D-dimer,MPV,red blood cell count,hemoglobin,fibrinogen,lymphocyte count and NLR of all subjects,then compared these between the two group.Logistic regression analysis was used to analyze the risk factors that may influence APE.Draw the ROC curve of early diagnosis of APE by RDW,MPV and their combination.In order to analyze its efficiency,we can know the area under the curve,and selecting the place with the largest Youden index.The sensitivity,specificity and other indicators corresponding to the cut-off value are obtained.Result:1.In the APE group and the control group,D-dimer was(4.49±2.50)mg/L vs(0.26±0.14)mg/L,platelet counts was(214.26±70.60)×10~9/L vs(238.06±48.11)×10~9/L,RDW was(14.67±1.25)%vs(13.42±0.70)%,MPV was(10.49±1.03)fL vs(9.58±0.82)fL,neutrophil count was(6.12±3.87)×10~9/L vs(4.20±1.74)×10~9/L,NLR was(6.15±7.27)vs(3.27±2.48),fibrinogen was(3.78±1.37)g/L vs(2.82±0.43)g/L.There were significant differences between the two groups(p<0.05).red blood cell count was(4.25±0.50)×10~9/L vs(5.34±0.40)×10~9/L,lymphocyte count was(1.35±0.69)×10~9/L vs(1.51±0.47)×10~9/L hemoglobin was(129.66±17.8)g/L vs(133.39±9.62)g/L.There was no significant difference between the two groups(p>0.05).2.After logistic regression analysis of APE related factors,RDW,MPV and NLR were all independent risk factors.3.When the RDW was used to diagnose APE,the ROC curve was analyzed and drawn.The area under the curve was 0.820,and its Youden index was the largest at the RDW of 14%,the corresponding sensitivity was 79.1%,the specificity was 75.5%,the positive predictive value was 76.3%,and the negative predictive value was 78.3%.4.When the MPV was used to diagnose APE,the ROC curve was analyzed and drawn.The area under the curve was 0.759,and the Youden index was the largest at the MPV of 9.65fL,with the corresponding sensitivity of 82.7%,specificity of 56.4%,positive predictive value of 65.5%and negative predictive value of 76.5%.5.When combine the RDW and MPV to diagnose APE,the area under the ROC curve was 0.881,the corresponding sensitivity was 81.8%,the specificity was 84.5%,the positive predictive value was 84.1%,and the negative predictive value was 82.3%.Conclusion:RDW and MPV are related to APE,which are helpful for the diagnosis of APE,and the combination of them has a higher diagnostic efficiency,which has a certain value for guiding the early clinical diagnosis.