主动脉瘤患者止血标志物与血小板指标之间的关系

Relationship between hemostatic markers and platelet indices in patients with aortic aneurysm.

作者信息

Ihara Akihiro, Matsumoto Kengo, Kawamoto Toshiharu, Shouno Saburou, Kawamoto Jun, Katayama Akira, Yoshitatsu Masao, Izutani Hironori

机构信息

Institute of Clinical Research, National Kure Medical Center, Hiroshima, Japan.

出版信息

Pathophysiol Haemost Thromb. 2006;35(6):451-6. doi: 10.1159/000102053.

DOI:10.1159/000102053

PMID:17565239

Abstract

The purpose of this study was to investigate whether platelet indices [platelet count, mean platelet volume (MPV), platelet-large cell ratio (P-LCR) and platelet distribution width (PDW)] could serve as diagnostic tools to evaluate the potential significance of platelet heterogeneity on thrombus formation in patients with aortic aneurysm (AA). Blood samples were obtained from 54 patients with AA (mean age 73 years; 40 males and 14 females), and from 120 age-matched controls (AC; mean age 74 years; 61 males and 59 females). Blood platelet indices were measured using an automated counter for all AC (n = 120) and AA (n = 54). Plasma thrombin-antithrombin III complex (TAT), alpha(2)-plasmin inhibitor-plasmin complex (PIC), D-dimer, von Willebrand factor antigen (vWF:Ag) and interleukin-6 (IL-6) were also measured in part of AC and AA. In AA patients, TAT, PIC, D-dimer, vWF:Ag and IL-6 levels were significantly (p < or =0.0005) higher than in AC. In the patients, TAT was significantly inversely correlated with platelet count (rho = -0.302, p = 0.038, n = 48), and significantly positively correlated with MPV (rho = 0.329, p = 0.0373, n = 48), P-LCR (rho = 0.361, p = 0.0134, n = 48) and PDW (rho = 0.315, p = 0.0466, n = 48). PIC was negatively correlated with platelet count and inversely correlated with MPV, P-LCR and PDW. vWF:Ag was not correlated with platelet count, and inversely correlated with MPV, P-LCR and PDW in the patients. IL-6 was positively correlated with platelet count, and significantly inversely correlated with MPV, P-LCR and PDW in the patients. In AC, vWF:Ag was inversely correlated with platelet count and significantly positively correlated with MPV, P-LCR and PDW. However, PIC, TAT and IL-6 were not correlated with platelet indices in AC. D-dimer was not at all correlated with platelet indices both in AA and AC. In conclusion, the correlation between platelet indices and plasma hemostatic factor levels, e.g. TAT, PIC, D-dimer, vWF:Ag and IL-6, will be important factors for the understanding of platelet heterogeneity in patients with AA.

摘要

本研究的目的是调查血小板指标[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）]是否可作为诊断工具，以评估血小板异质性对主动脉瘤（AA）患者血栓形成的潜在意义。从54例AA患者（平均年龄73岁；40例男性和14例女性）以及120例年龄匹配的对照者（AC；平均年龄74岁；61例男性和59例女性）中采集血样。使用自动计数器对所有AC（n = 120）和AA（n = 54）测量血小板指标。还对部分AC和AA测量了血浆凝血酶-抗凝血酶III复合物（TAT）、α2-纤溶酶抑制剂-纤溶酶复合物（PIC）、D-二聚体、血管性血友病因子抗原（vWF:Ag）和白细胞介素-6（IL-6）。在AA患者中，TAT、PIC、D-二聚体、vWF:Ag和IL-6水平显著高于AC（p≤0.0005）。在患者中，TAT与血小板计数显著负相关（rho = -0.302，p = 0.038，n = 48），与MPV显著正相关（rho = 0.329，p = 0.0373，n = 48）、P-LCR（rho = 0.361，p = 0.0134，n = 48）和PDW（rho = 0.315，p = 0.0466，n = 48）。PIC与血小板计数呈负相关，与MPV、P-LCR和PDW呈负相关。在患者中，vWF:Ag与血小板计数无相关性，与MPV、P-LCR和PDW呈负相关。IL-6与血小板计数呈正相关，在患者中与MPV、P-LCR和PDW显著负相关。在AC中，vWF:Ag与血小板计数呈负相关，与MPV、P-LCR和PDW显著正相关。然而，PIC、TAT和IL-6与AC中的血小板指标无相关性。D-二聚体在AA和AC中均与血小板指标完全无相关性。总之，血小板指标与血浆止血因子水平（如TAT、PIC、D-二聚体、vWF:Ag和IL-6）之间的相关性将是理解AA患者血小板异质性的重要因素。