Ertaş Gökhan, Kozdağ Güliz, Emre Ender, Akay Yaşar, Ural Dilek, Hebert Kathy
Department of Cardiology, Gümüşhane State Hospital, Gumushane, Turkey.
Blood Coagul Fibrinolysis. 2012 Mar;23(2):127-31. doi: 10.1097/MBC.0b013e32834ee144.
Mean platelet volume (MPV) is increased in chronic heart failure (CHF) and is an independent predictor of mortality in CHF patients. It is not known whether enhanced external counterpulsation (EECP) therapy leads to decreased MPV values or not. The purpose of this study was to examine the effects of EECP on platelet count and MPV values and to assess the influence of MPV on the risk of death and recurrent ischemic events in ischemic CHF patients. A total of 68 ischemic heart failure patients with CHF symptoms and refractory angina pectoris were included in the study, 47 consecutive patients (39 males and eight females) aged 44-82 years. Although follow-up period started after completion of EECP in treated patients, control group follow-up started at the end of 7-week treatment without EECP. All patients were monitored for a mean duration of 13 ± 8 months (range, 1-36 months). The primary endpoints of the study were effects of EECP treatment on platelets after treatment period (7 weeks) and the recurrence of ischemic events. Secondary endpoint was cardiovascular death during the follow-up period. We observed a significant increase in platelet count and decrease in MPV levels (P = 0.044 and P = 0.004, respectively) in the control group. There were no significant differences in platelet count and MPV levels in the EECP group (P > 0.05). After the treatment period, New York Heart Association functional classification (2.60 ± 0.75 vs. 1.72 ± 0.68, P < 0.001) and Canadian Cardiovascular Society functional classification of angina (2.50 ± 0.90 vs. 1.60 ± 0.74, P < 0.001) improved in patients with EECP treatment. In our study, we found that EECP therapy had a neutral effect on MPV values and platelet count.
慢性心力衰竭（CHF）患者的平均血小板体积（MPV）升高，且是CHF患者死亡率的独立预测指标。目前尚不清楚增强型体外反搏（EECP）治疗是否会导致MPV值降低。本研究的目的是探讨EECP对血小板计数和MPV值的影响，并评估MPV对缺血性CHF患者死亡风险和复发性缺血事件的影响。本研究共纳入68例有CHF症状和难治性心绞痛的缺血性心力衰竭患者，其中连续47例患者（39例男性和8例女性），年龄44 - 82岁。虽然治疗组患者在EECP治疗结束后开始随访，但对照组在无EECP的7周治疗结束时开始随访。所有患者的平均监测时间为13±8个月（范围1 - 36个月）。本研究的主要终点是治疗期（7周）后EECP治疗对血小板的影响以及缺血事件的复发情况。次要终点是随访期内心血管死亡情况。我们观察到对照组血小板计数显著增加，MPV水平降低（分别为P = 0.044和P = 0.004）。EECP组的血小板计数和MPV水平无显著差异（P>0.05）。治疗期后，接受EECP治疗的患者纽约心脏协会功能分级（2.60±0.75 vs. 1.72±0.68，P<0.001）和加拿大心血管学会心绞痛功能分级（2.50±0.90 vs. 1.60±0.74，P<0.001）得到改善。在我们的研究中，我们发现EECP治疗对MPV值和血小板计数具有中性作用。
