Predictive Value Of RDW And MLPR In Patients With AECOPD And PE

Objective:1.To analyze the expression of erythrocyte distribution width（RDW）,monocyte to large platelet ratio（MLPR）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）complicated with pulmonary embolism（PE）,and to explore the relationship between RDW,MLPR and pulmonary embolism in AECOPD.2.To explore the value of RDW and MLPR in predicting the occurrence of PE in patients with AECOPD,and to provide basis for clinical judgment of the disease.Methods:1.patients with AECOPD hospitalized in three wards of the Department of Respiratory Medicine at the Affiliated Hospital of Yan’an University from September 2019 to September 2022 were retrospectively collected and clearly diagnosed with AECOPD combined with PE and AECOPD based on the results of spiral CT pulmonary arteriography（CTPA）.A total of 86 patients were included and divided into 45 patients in the AECOPD group and 45 patients in the AECOPD combined with PE group 41 patients.2.Age,gender,body mass index（BMI）,smoking history,diastolic blood pressure,systolic blood pressure,pulse,RDW,RBC,Hb,MONO,large platelet count（LPC）,monocyte/large platelet ratio（MLPR）,PCO₂,PO₂,PH,D-dimer,fibrinogen degradation product（FDP）,fibrinogen（FIB）,C-reactive protein（CRP）,calcitoninogen（PCT）,and B-type brain natriuretic peptide（BNP）.3.The data were imported into SPSS24.0statistical software for statistical analysis to compare the differences in the expression of each index in AECOPD patients with combined PE and AECOPD patients,and the correlation between the indexes was analyzed using spearman correlation coefficient,and the correlation between the indexes was analyzed using multi-factor Logistic regression and ROC curve analysis were used to explore the risk factors for the development of PE in AECOPD patients,and to assess the value of RDW and MLPR in predicting concurrent PE in AECOPD patients.Result:1.In this study,41 patients with AECOPD combined with PE and 45patients with AECOPD were collected,and there was no statistically significant difference between the two groups in terms of gender,age,BMI,smoking history,blood pressure,and pulse rate（P>0.05）.2.In the comparison of laboratory indexes,MLPR,MONO,RDW,D-dimer,and FDP in the AECOPD combined with PE group were greater than those in the AECOPD group,and the difference was statistically significant（P<0.05）;Pa CO2 was lower in the AECOPD combined with PE group than in the AECOPD group,and the difference was statistically significant（P<0.05）;the remaining laboratory indexes were not The remaining laboratory indicators were not statistically significant（P>0.05）.Correlation analysis showed positive correlation between RDW and MLPR,FDP,D-dimer（r=0.308 P=0.015;r=0.415 P=0.001;r=0.402 P=0.001）,negative correlation between RDW and LPC（r=-0.214 P=0.048）,positive correlation between MLPR and FDP,MONO,D-dimer There was a positive correlation between RDW and LPC（r=0.588P<0.001;r=0.783 P<0.001;r=0.495 P<0.001）,and a negative correlation between MLPR and LPC（r=-0.691 P<0.001）;multifactorial logistic regression analysis showed that RDW,MLPR and D-dimer may be risk factors for the development of PE in AECOPD patients.The multifactorial logistic regression analysis showed that RDW,MLPR and D-dimer may be risk factors for the complication of PE in patients with AECOPD,with OR values of 1.567,5.923and 2.787,respectively.3.ROC curve analysis showed that the AUC values of RDW,MLPR and D-dimer alone for predicting concurrent PE in AECOPD patients were 0.680,0.822 and 0.785,respectively,and the best critical values were 1.211%,14.65%and 2.02 mg/L,respectively,with sensitivity and specificity of 88.9%and48.8%,77.8%and 75.6%,91.1%and 56.1%;the AUC values of RDW+D-dimer,MLPR+D-dimer and RDW+MLPR+D-dimer were 0.837,0.883,0.851 and 0.903,respectively,and their sensitivity and specificity were 82.2%and 75.6%,80.0%and 82.9%,84.4%and 73.2%,88.9%,and 80.5%,respectively.Conclusion:1.peripheral blood RDW,MLPR and D-dimer were significantly increased in patients with AECOPD combined with PE,and increased RDW,MLPR and D-dimer may be independent risk factors for the development of pulmonary embolism in patients with AECOPD;2.Combined detection of RDW,MLPR and D-dimer can improve the diagnostic efficacy of AECOPD patients with co-morbid PE,and the combined detection of the three tests is better than each individual prediction,which can be used as a laboratory index for early diagnosis of AECOPD combined with PE.