Neurology Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Intern Med J. 2011 Sep;41(9):691-5. doi: 10.1111/j.1445-5994.2009.02162.x.
Mean platelet volume (MPV) was shown to be significantly increased in patients with acute ischaemic stroke, especially in non-lacunar strokes. Moreover, some studies concluded that increased MPV is related to poor functional outcome after ischaemic stroke, although this association is still controversial. However, the determinants of MPV in patients with acute ischaemic stroke have never been investigated.
We recorded the main demographic, clinical and laboratory data of consecutive patients with acute (admitted within 24 h after stroke onset) ischaemic stroke admitted in our Neurology Service between January 2003 and December 2008. MPV was generated at admission by the Sysmex XE-2100 automated cell counter (Sysmex Corporation, Kobe, Japan) from ethylenediaminetetraacetic acid blood samples stored at room temperature until measurement. The association of these parameters with MPV was investigated in univariate and multivariate analysis.
A total of 636 patients was included in our study. The median MPV was 10.4 ± 0.82 fL. In univariate analysis, glucose (β= 0.03, P= 0.05), serum creatinine (β= 0.002, P= 0.02), haemoglobin (β= 0.009, P < 0.001), platelet count (β=-0.002, P < 0.001) and history of arterial hypertension (β= 0.21, P= 0.005) were found to be significantly associated with MPV. In multivariate robust regression analysis, only hypertension and platelet count remained as independent determinants of MPV.
In patients with acute ischaemic stroke, platelet count and history of hypertension are the only determinants of MPV.
平均血小板体积（MPV）在急性缺血性脑卒中患者中显著增加，尤其是在非腔隙性脑卒中患者中。此外，一些研究得出结论，MPV 升高与缺血性脑卒中后的不良功能结局相关，尽管这种关联仍存在争议。然而，急性缺血性脑卒中患者的 MPV 决定因素从未被研究过。
我们记录了 2003 年 1 月至 2008 年 12 月期间在我们神经内科连续收治的急性（发病后 24 小时内入院）缺血性脑卒中患者的主要人口统计学、临床和实验室数据。在室温下储存 EDTA 抗凝血样本，直到测量时，使用 Sysmex XE-2100 自动血细胞计数器（Sysmex 公司，神户，日本）生成入院时的 MPV。使用单变量和多变量分析研究这些参数与 MPV 的关系。
我们的研究共纳入 636 例患者。MPV 的中位数为 10.4±0.82fL。在单变量分析中，血糖（β=0.03，P=0.05）、血清肌酐（β=0.002，P=0.02）、血红蛋白（β=0.009，P<0.001）、血小板计数（β=-0.002，P<0.001）和动脉高血压史（β=0.21，P=0.005）与 MPV 显著相关。在多变量稳健回归分析中，只有高血压和血小板计数仍然是 MPV 的独立决定因素。
在急性缺血性脑卒中患者中，血小板计数和高血压史是 MPV 的唯一决定因素。
