Clinical Value of Mean Platelet Volume/Lymphocyte Ratio in Differentiating Community-Acquired Pneumonia with Pulmonary Embolism in Elderly Patients

LIU Lisha; MA Xiaohua; XIE Renfeng; LIU Fang; TAN Aichun

doi:10.3639/j.issn.2095-3097.2025.06.011

Abstract：Objective To investigate the clinical value of mean platelet volume/lymphocyte ratio(MPVLR)in differ-entiating elderly patients with community-acquired pneumonia(CAP)complicated with pulmonary embolism.Methods A total of 178 elderly patients with CAP admitted to the Changsha Central Hospital from April 2020 to October 2023 were retro-spectively selected as the CAP group,and 35 elderly patients with CAP combined with pulmonary embolism were selected as the combined pulmonary embolism group.The mean platelet volume(MPV)and lymphocyte(LYM)levels in peripheral blood of patients in the two groups were detected by automatic blood cell analyzer,and the MPVLR was calculated.The differentiating value of MPV,LYM,and MPVLR in peripheral blood for elderly patients with CAP complicated with pulmonary embolism was evaluated using ROC curves.The influencing factors of CAP and pulmonary embolism in elderly patients were explored by mul-tivariate Logistic regression.Results The level of MPV and MPVLR in peripheral blood of patients in the pulmonary embolism group was higher than that of the CAP group,and the level of peripheral blood LYM was lower than that of the CAP group with statistical difference(P<0.05).The area under the curve(AUC)[95%confidence interval(CI)]of MPV,LYM and MPVLR in peripheral blood for differentiating CAP with pulmonary embolism in elderly patients were 0.871(0.820-0.923),0.762(0.711-0.814)and 0.904(0.853-0.956),respectively.Cut-off values were 10.41 fl,1.47×109,and 10.79,with specificity of 0.680,0.569,0.869,and sensitivity of 0.909,0.908,0.886,respectively.The age of patients in the pulmonary embolism group was higher than that of the CAP group,and the proportion of total pulmonary lobar involvement,pleural effusion,atelectasis,as well as D-D and FIB levels were higher than those of the CAP group with statistical difference(P<0.05).Older age,pleural effusion,increased D-D level,MPV≥10.41 fl,and MPVLR≥10.79 were independent risk factors for CAP combined with pulmonary embolism(OR>1)(P<0.05).Conclusion MPVLR is elevated in elderly patients with CAP complicated with pulmonary em-bolism,and it has good diagnostic value in the differential diagnosis of pulmonary embolism in elderly patients with CAP,which can be used as a potential biomarker.