Ihara Akihiro, Kawamoto Toshiharu, Matsumoto Kengo, Shouno Saburou, Hirahara Chiemi, Morimoto Tadao, Noma Yasuharu
Department of Hematology, National Hospital Organization Kure Medical Center, Hiroshima, Japan.
Pathophysiol Haemost Thromb. 2006;35(5):376-9. doi: 10.1159/000097692.
To understand the mechanisms linking platelets to the risk of coronary artery disease, we investigated the relation between coronary angiographic morphology and platelet indexes--platelet count, mean platelet volume (MPV), platelet-large cell ratio (P-LCR) and platelet distribution width (PDW)--in patients with ischemic heart disease. Eighty-four patients with ischemic heart disease and 120 aged controls (AC) were enrolled in the study. The patients without any signs of acute myocardial infarction and acute coronary syndromes who underwent coronary angiography were divided into two groups, an 'angiographically negative group' (group 0) and an 'angiographically positive group' (group 1), with positive coronary obstruction depending on the diagnostic criteria in our hospital. Platelet indexes were measured in peripheral venous blood. The mean platelet counts were significantly lower in groups 1 and 0 than in AC (p = 0.0128 and p = 0.0041, respectively). MPV, P-LCR and the PDW were significantly higher in group 0 than in group 1 and AC (p = 0.0352 and 0.0433, p = 0.0059 and 0.0052, p = 0.00461 and 0.0146, respectively). The indexes of group 1 were almost the same compared with AC with respect to MPV, P-LCR and PDW. In conclusion, these findings suggest that the measurement of platelet indexes may reflect the underlying pathophysiological state and subsequent clinical events in the patients. In particular, lower P-LCR seems to identify patients with positive coronary angiography.
为了解血小板与冠状动脉疾病风险之间的关联机制,我们研究了缺血性心脏病患者冠状动脉造影形态与血小板指标(血小板计数、平均血小板体积(MPV)、血小板大细胞比率(P-LCR)和血小板分布宽度(PDW))之间的关系。本研究纳入了84例缺血性心脏病患者和120例老年对照者(AC)。对无急性心肌梗死和急性冠状动脉综合征迹象且接受冠状动脉造影的患者,根据我院诊断标准,将冠状动脉阻塞阳性者分为两组,即“造影阴性组”(0组)和“造影阳性组”(1组)。检测外周静脉血中的血小板指标。1组和0组的平均血小板计数均显著低于老年对照者(分别为p = 0.0128和p = 0.0041)。0组的MPV、P-LCR和PDW显著高于1组和老年对照者(分别为p = 0.0352和0.0433、p = 0.0059和0.0052、p = 0.00461和0.0146)。1组在MPV、P-LCR和PDW方面的指标与老年对照者几乎相同。总之,这些研究结果表明,血小板指标的检测可能反映患者潜在的病理生理状态及后续临床事件。特别是,较低的P-LCR似乎可识别冠状动脉造影阳性的患者。