The Value Of Mean Platelet Volume And Platelet/Lymphocyte Ratio In Predicting The Occurrence Of Delayed Encephalopathy After Acute Carbon Monoxide Poisoning

Objective: To explore the value of mean platelet volume and platelet/lymphocyte ratio in predicting the occurrence of delayed encephalopathy after acute carbon monoxide poisoning.Method: A total of 102 patients with acute carbon monoxide poisoning and delayed encephalopathy,from 18 to 65 years old,admitted in the emergency and neurology department of the Affiliated Hospital of North Sichuan Medical College from January 1,2015 to December 31,2018.According to the severity,the patients were divided into mild group(15 cases),moderate group(63 cases),and severe group(24 cases).According to whether delayed type encephalopathy occurred or not,the patients were divided into DEACMP group(17 cases)and Non-delayed encephalopathy group(85 cases).As a control group,60 healthy volunteers were enrolled in the physical examination center at the same hospital.The basic data(sex,age,past medical history,etc.),blood routines [White blood cell(WBC),platelet,lymphocytes(LY),MPV,etc.,and calculated data PLR],glasgow coma scale(GCS)score,carboxy-hemoglobin(COHb)] were collected from the clinical cases.Compare the differences between the groups MPV,PLR and GCS scores were analyzed by Pearson correlation analysis.The receiver operating characteristic curve(ROC)was used to calculate the sensitivity and specificity of MPV,PLR and their combination on the occurrence of delayed encephalopathy in patients with acute carbon monoxide poisoning.Results: Compared Compared with the control group,the MPV value and PLR value of the patients with acute carbon monoxide poisoning were significantly higher than those of the control group,and the difference was statistically significant(P < 0.05).In patients with acute carbon monoxide poisoning,the MPV value and PLR value increased gradually with the increase of severity.The MPV value and PLR value in the moderate group were significantly higher than that in the mild group,and while MPV value and PLR value in the severe group significantly higher than those in the mild and moderate groups,with statistically significant differences(P < 0.05).Pearson correlation analysis suggested that there was a negative correlation between MPV and GCS score(r=-0.453).There was a negative correlation between PLR and GCS score(r=-0.621).The ROC curve suggested that the best predicted values of DEACMP in MPV and PLR was 14.0 and 185.0,respectively.The AUC of MPV,PLR and the combination of DEACMP was 0.846,0.862 and 0.881,and the sensitivity was 79.28%,89.54% and 82.33%,specificity was 85.08%,82.71%,83.76%,respectively.Conclusion: The MPV value and PLR value of patients with acute carbon monoxide poisoning may reflect the severity of poisoning,the higher the MPV and PLR levels,the more serious the disease.MPV,PLR and their combination have certain value in predicting the occurrence of delayed encephalopathy,and the combination of MPV and PLR may have more predictive value than the single prediction of MPV and PLR.Patients with acute carbon monoxide poisoning with MPV 14.0 and PLR 185.0 were more likely to develop delayed encephalopathy.It is suggested that PLR and MPV values at admission should be used as reference indicators for predicting the occurrence of delayed encephalopathy.