ObjectiveTo investigate the prognostic value of platelet volume indices ［mean platelet volume (MPV) and platelet distribution width (PDW)］ in early period for patients with sepsis .MethodsThis retrospective study was conducted in a general ICU at a University Hospital from January 2015 to January 2017. Patients with sepsis were divided into a survival group and a death group according to 28-day prognosis. The demographic and clinical data were recorded and analyzed, including platelet indices, Charlson comorbidity index, Glasgow Coma Scale (GCS) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score. Multivariable COX proportional hazard ratio model was used to evaluate the 28-day mortality risk, and receiver operating characteristic (ROC) curve were used to evaluate the value of platelet volume indices.ResultsA total of 209 patients were enrolled in this study. Mean arterial pressure, pH, platelet count, serum creatinine, bilirubin, troponin I, prothrombin time, GCS score and platelet volume indices showed significant differences between the survival group (n=137) and the death group (n=72) (all P<0.05). Multivariable COX regression analysis revealed that the PDW was independently associated with 28-day mortality in sepsis (HR=1.068, 95%CI 1.002-1.139, P=0.043). The area under the ROC curve of PDW was 0.762 (95%CI 0.694 - 0.831), with a sensitivity of 86% and a specificity of 63% at a cut-off value of 18.65%.ConclusionPDW can be used as a powerful prognostic indicator in patients with sepsis following 28-day.
ObjectiveTo observe the correlation between blood cell-related inflammatory markers and diabetic retinopathy (DR). MethodsA cross-sectional study. From June 2020 to February 2022, the phase Ⅰ data of Beichen Eye Study in Tianjin Medical University Eye Hospital were included in the study. The research contents included questionnaires, routine systemic and ocular examinations, and laboratory blood cell-related indicators including mean platelet volume (MPV), platelet distribution width (PDW), neutrophils, and lymphocytes were performed. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were calculated. The diagnosis and classification of DR referred to the international clinical classification standard of DR. Monocular or binocular DR was defined as DR patients. Participants were categorized into different groups based on whether they had diabetes and whether they had DR. The groups included the no-diabetes group, the diabetes without DR group, and the DR group. The Kruskal-Wallis H test was used for the comparison of quantitative data among multiple groups. Wilcoxon test was used for comparison between the two groups. The χ2 test was used to compare the categorical variables between groups. The variables was adjusted step by step, an unadjusted univariate model was built and the different parameters of the model Ⅰ, Ⅱ, Ⅲ were adjusted. The correlation between MPV, PDW, NLR, PLR, and DR in different models was analyzed by logistic regression. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of different NLR models for DR. ResultsA total of 3 328 subjects were recruited. Among them, 1 121 (33.68 %, 1 121/3 328) were males and 2 207 (66.32 %, 2 207/3 328) were females. The median age of the included participants was 61.84 (6.05) years. The no-diabetes group, the diabetes without DR group, and the DR group were 2 679, 476, and 173, respectively. There was no significant difference in MPV and PLR among the three groups (H=5.98, 1.94; P=0.051, 0.379). However, compared with no-diabetes group and the diabetes without DR group, PDW and NLR in the DR group showed an upward trend. In model Ⅲ with completely adjusted related factors, NLR was an independent risk factor for DR in no-diabetes group and DR group [odds ratio (OR)=1.440, 95% confidence interval (CI) 1.087-1.920, P=0.041], diabetes without DR group and DR group [OR=1.990, 95% CI 1.440-2.749, P＜0.001]. The results of ROC curve analysis showed that the diagnostic efficiency of NLR model Ⅲ was the highest, the area under the curve was 0.751 (95%CI 0.706-0.796, P＜0.001), the optimal cutoff value was 0.390, and the sensitivity and specificity were 74.3% and 64.8%, respectively. ConclusionsThe NLR of the DR group is significantly higher than that of the no-diabetes group and diabetes without DR group. NLR is an independent risk factor for DR.