Akpek Mahmut, Kaya Mehmet G, Yarlioglues Mikail, Dogdu Orhan, Ardic Idris, Sahin Omer, Elcik Deniz, Ozdogru Ibrahim, Topsakal Ramazan, Oguzhan Abdurrahman, Ergin Ali, Kalay Nihat
Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
Eur J Echocardiogr. 2011 Nov;12(11):865-70. doi: 10.1093/ejechocard/jer159. Epub 2011 Sep 5.
To determine the association of platelet indices with spontaneous echo contrast (SEC) in patients with mitral stenosis.
A total of 232 consecutive patients with mitral stenosis who undergoing mitral balloon valvuloplasty were enrolled to the study. Patients were divided into two groups according to the formation of SEC in the left atrium. Group 1: mitral stenosis complicated with SEC; Group 2: mitral stenosis without SEC. Transthoracic echocardiography and transoesophageal echocardiography were performed for each patient. Complete blood counting parameters were measured and all routine biochemical tests were performed. There were 133 patients (mean age 42 ± 11 and 74% female) in the SEC(-) group and 99 patients (mean age 45 ± 10 and 64% female) in the SEC(+) group. Plateletcrit (0.25 ± 0.06 vs. 0.27 ± 0.07, P = 0.043) and mean platelet volume (MPV) levels (9.4 ± 1.1 vs. 10.4 ± 1.2, P < 0.001) were significantly higher in the SEC(+) group. When we divided the SEC(+) patients into four subgroups according to previously reported criteria, MPV levels increased to correlate with the degree of SEC (P < 0.001). At multivariate analysis, MPV levels [odds ratio (OR) 2.365, 95% confidence interval (CI) 1.720-3.251; P < 0.001] and PCT levels (OR 2.699, 95% CI 1.584-4.598; P= 0.033) are independent risk factors of SEC in patients with mitral stenosis.
In patients with mitral stenosis, cheaply and easily measurable platelet indices including MPV and PCT levels are associated with the presence of SEC and are independent risk factors of SEC.
确定二尖瓣狭窄患者血小板指标与自发显影（SEC）之间的关联。
连续纳入232例行二尖瓣球囊成形术的二尖瓣狭窄患者进行研究。根据左心房SEC的形成情况将患者分为两组。第1组：二尖瓣狭窄合并SEC；第2组：二尖瓣狭窄不合并SEC。对每位患者进行经胸超声心动图和经食管超声心动图检查。检测全血细胞计数参数并进行所有常规生化检查。SEC（-）组有133例患者（平均年龄42±11岁，女性占74%），SEC（+）组有99例患者（平均年龄45±10岁，女性占64%）。SEC（+）组的血小板压积（0.25±0.06 vs. 0.27±0.07，P = 0.043）和平均血小板体积（MPV）水平（9.4±1.1 vs. 10.4±1.2，P < 0.001）显著更高。当我们根据先前报道的标准将SEC（+）患者分为四个亚组时，MPV水平升高与SEC程度相关（P < 0.001）。多因素分析显示，MPV水平[比值比（OR）2.365，95%置信区间（CI）1.720 - 3.251；P < 0.001]和血小板比容（PCT）水平（OR 2.699，95% CI 1.584 - 4.598；P = 0.033）是二尖瓣狭窄患者SEC的独立危险因素。
在二尖瓣狭窄患者中，包括MPV和PCT水平在内的易于测量且成本低廉的血小板指标与SEC的存在相关，并且是SEC的独立危险因素。
