Rupa-Matysek Joanna, Gil Lidia, Wojtasińska Ewelina, Ciepłuch Katarzyna, Lewandowska Maria, Komarnicki Mieczysław
Department of Haematology, Poznan University of Medical Sciences, Szamarzewskiego 84, 60-569, Poznan, Poland,
Rheumatol Int. 2014 Nov;34(11):1599-605. doi: 10.1007/s00296-014-2996-0. Epub 2014 Mar 27.
Increased mean platelet volume (MPV) is associated with platelet reactivity and is a predictor of cardiovascular risk and unprovoked venous thromboembolism. The aim of our study was to evaluate MPV in patients with confirmed antiphospholipid antibody syndrome (APS) and to identify the correlation between the value of MPV and the recurrence of thrombosis. The studied group consists of 247 patients with a history of thrombosis and/or pregnancy loss (median age 38, range 18-66 years) classified as APS group (n = 70) or APS negative patients (n = 177) according to the updated Sapporo criteria. The control group consisted of 98 healthy subjects. MPV was significantly higher in the group of patients with clinically and laboratory confirmed APS (median 7.85, range 4.73-12.2 fl) in comparison with the controls. It was also higher than in APS negative patients (7.61, range 5.21-12.3 fl). APS patients with triple positivity for antiphospholipid antibodies with respect to Miyakis classification categories had higher MPV values than other APS patients (9.69 ± 1.85 vs. 7.29 ± 1.3 fl, p = 0.001). Recurrent thrombotic episodes were observed in 83 patients, but among the triple positive high-risk patients with APS in 80 % cases (p = 0.0046). In receiver operating characteristic curve analysis, the value of MPV level for thrombosis recurrence prediction in the APS group with sensitivity of 86 % and specificity of 82 % was 7.4 fl. In the multivariate logistic regression model, MPV above 7.4 fl (OR 3.65; 95 % CI 1.38-9.64, p = 0.009) significantly predicts thrombosis recurrence. Our results identify the value of MPV as a prognostic factor of thrombosis recurrence in patients with APS.
平均血小板体积（MPV）升高与血小板反应性相关，是心血管风险和不明原因静脉血栓栓塞的预测指标。我们研究的目的是评估确诊抗磷脂抗体综合征（APS）患者的MPV，并确定MPV值与血栓形成复发之间的相关性。研究组由247例有血栓形成和/或流产史的患者组成（中位年龄38岁，范围18 - 66岁），根据更新的札幌标准分为APS组（n = 70）或APS阴性患者（n = 177）。对照组由98名健康受试者组成。与对照组相比，临床和实验室确诊的APS患者组的MPV显著更高（中位值7.85，范围4.73 - 12.2 fl）。它也高于APS阴性患者（7.61，范围5.21 - 12.3 fl）。在宫木分类类别中抗磷脂抗体三联阳性的APS患者的MPV值高于其他APS患者（9.69±1.85 vs. 7.29±1.3 fl，p = 0.001）。83例患者出现复发性血栓事件，但在APS三联阳性高危患者中占80%（p = 0.0046）。在受试者工作特征曲线分析中，APS组中用于预测血栓形成复发的MPV水平值，敏感性为86%，特异性为82%，为7.4 fl。在多因素逻辑回归模型中，MPV高于7.4 fl（OR 3.65；95%CI 1.38 - 9.64，p = 0.009）显著预测血栓形成复发。我们的结果确定了MPV作为APS患者血栓形成复发预后因素的价值。
