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血小板平均体积和血小板计数在缺血性和出血性卒中的预后作用。

Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke.

机构信息

Department of First Neurology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.

出版信息

J Stroke Cerebrovasc Dis. 2010 Jan;19(1):66-72. doi: 10.1016/j.jstrokecerebrovasdis.2009.03.003.

DOI:10.1016/j.jstrokecerebrovasdis.2009.03.003
PMID:20123229
Abstract

BACKGROUND

Mean platelet volume (MPV) is an indicator of platelet function or reactivity. Platelets play an important role in the pathophysiology of ischemic stroke but the effect of platelet count (PC) and dysfunction in the pathogenesis of hemorrhagic stroke is poorly understood. We have investigated the possibility of MPV and PC being an independent risk factor of ischemic and haemorrhagic stroke and their effect on prognosis.

METHODS

We prospectively studied 692 patients with either ischemic or hemorrhagic stroke and compared them with 208 control subjects with similar risk factors, but without evidence of vascular events. The association of MPV and PC with cause, localization, and size of the infarct or hemorrhage was examined. Prognosis was determined by Glasgow Outcome Scale. By multivariate logistic regression analysis, the influence of MPV and PC on stroke subtype and prognosis was determined.

RESULTS

MPV and PC were observed as independent risk factors for ischemic stroke (P = .007, odds ratio [OR] = 0.866; P = .000, OR = 0.996; 95% confidence interval [CI], respectively). There was a negative and significant correlation between PC and hemorrhagic stroke (P = .001), but no association was found with MPV (P > .05). MPV and PC were not statistically significant related to etiological subgroups, localization, and size of the infarct or hemorrhage (P > .05). Ischemic group MPV (P = .013, OR = 1.02, 95% CI) and hemorrhagic group PC were in correlation with worse outcome (P = .001, OR = 1.004, 95% CI).

CONCLUSION

MPV, may be an early and important predictor for the prognosis of ischemic stroke, whereas for hemorrhagic stroke PC has a role for outcome.

摘要

背景

平均血小板体积(MPV)是血小板功能或反应性的指标。血小板在缺血性中风的病理生理学中起着重要作用,但血小板计数(PC)和功能障碍在出血性中风发病机制中的作用尚不清楚。我们研究了 MPV 和 PC 是否是缺血性和出血性中风的独立危险因素及其对预后的影响。

方法

我们前瞻性研究了 692 例缺血性或出血性中风患者,并将其与 208 例具有相似危险因素但无血管事件证据的对照组进行了比较。检查了 MPV 和 PC 与梗死或出血的原因、定位和大小的关系。通过格拉斯哥结局量表确定预后。通过多变量逻辑回归分析,确定了 MPV 和 PC 对中风亚型和预后的影响。

结果

MPV 和 PC 被观察为缺血性中风的独立危险因素(P =.007,优势比 [OR] = 0.866;P =.000,OR = 0.996;95%置信区间 [CI])。PC 与出血性中风呈负相关且具有统计学意义(P =.001),但与 MPV 无关(P >.05)。MPV 和 PC 与病因亚组、定位和梗死或出血的大小无统计学显著相关性(P >.05)。缺血组 MPV(P =.013,OR = 1.02,95% CI)和出血组 PC 与预后较差相关(P =.001,OR = 1.004,95% CI)。

结论

MPV 可能是缺血性中风预后的早期和重要预测指标,而 PC 在出血性中风中对预后有一定作用。

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