Sharp D S, Beswick A D, O'Brien J R, Renaud S, Yarnell J W, Elwood P C
Medical Research Council Epidemiology Unit, Cardiff, United Kingdom.
Thromb Haemost. 1990 Oct 22;64(2):211-5.
This epidemiological study was undertaken to explore possible relationships among various haematological indices, prevalent ischaemic heart disease and platelet "function" as measured by two rather different methods. ADP-induced platelet impedance changes in whole blood were strongly associated with prevalent ischaemic heart disease in a general population of 49-66 year men at increased risk. Adenosine diphosphate (ADP) induced platelet aggregation in platelet rich plasma (PRP) at a constant platelet count and also the whole blood platelet count and red cell (RBC) count were strongly and independently related to ADP-induced platelet impedance changes. Both platelet count and platelet aggregation in PRP assessed by changes in optical density were directly related to increasing platelet "sensitivity" as measured by impedance changes in whole blood but RBC count was inversely related. Positive independent relationships between platelet impedance changes and plasma viscosity and fibrinogen were markedly attenuated when platelet count was taken into account, but this finding does not discount a role for these factors in platelet aggregation. No relationship was noted between white blood cell (WBC) count and platelet impedance changes; however, a significant inverse relationship was noted with platelet aggregation in PRP. These findings indicate that laboratory-based experimental findings can be observed in population based studies, and that these haematological factors may be important indicators of ischaemic disease in the population.
本流行病学研究旨在探讨通过两种截然不同的方法所测量的各种血液学指标、缺血性心脏病患病率与血小板“功能”之间可能存在的关系。在49至66岁风险增加的男性普通人群中,ADP诱导的全血血小板阻抗变化与缺血性心脏病患病率密切相关。在血小板计数恒定的情况下,二磷酸腺苷(ADP)诱导富血小板血浆(PRP)中的血小板聚集,并且全血血小板计数和红细胞(RBC)计数与ADP诱导的血小板阻抗变化密切且独立相关。通过光密度变化评估的PRP中的血小板计数和血小板聚集均与通过全血阻抗变化测量的血小板“敏感性”增加直接相关,但RBC计数与之呈负相关。当考虑血小板计数时,血小板阻抗变化与血浆粘度和纤维蛋白原之间的正独立关系明显减弱,但这一发现并不排除这些因素在血小板聚集中的作用。未发现白细胞(WBC)计数与血小板阻抗变化之间存在关系;然而,发现其与PRP中的血小板聚集存在显著负相关。这些发现表明,基于实验室的实验结果可以在基于人群的研究中观察到,并且这些血液学因素可能是人群中缺血性疾病的重要指标。