Prodan Calin I, Vincent Andrea S, Dale George L
1 Veterans Administration Medical Center and Department of Neurology, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma.
2 Cognitive Science Research Center, University of Oklahoma , Norman, Oklahoma.
J Neurotrauma. 2016 May 1;33(9):818-24. doi: 10.1089/neu.2014.3846. Epub 2015 Oct 27.
Coated-platelets are procoagulant platelets that are elevated in stroke and are associated with stroke recurrence. In a previous study, prompted by data showing an increased risk for stroke following traumatic brain injury (TBI), we found that coated-platelet levels are elevated in patients with combat-related mild TBI (mTBI) several years after the injury, compared with controls. We now investigate in an expanded patient population whether parameters commonly recorded in mTBI are related to increased coated-platelet potential. Coated-platelet levels were assayed in 120 mTBI patients at intervals ranging from 6 months to 10 years from the last injury. Correlations were calculated between coated-platelet levels and age, gender, race/ethnicity, loss of consciousness, alteration in consciousness, post-traumatic amnesia, number of injuries, mechanism of injury, time since first and last injury, smoking, medications that may influence coated-platelet levels, and pertinent comorbid conditions. Significant correlations were detected between coated-platelet levels and number of injuries (p = 0.026), gender (p = 0.01), and time since last injury (p = 0.04). A multi-variable linear model analysis, including these three parameters and an additional three parameters (race/ethnicity, smoking, and mechanism of injury) that reached a p value of <0.2, showed that the number of injuries were predictive of coated-platelet levels (p = 0.004). These results support a mechanistic link between increased coated-platelet levels and repeated injuries in mTBI. Long-term studies will be required to determine the impact of increased prothrombotic potential in mTBI patients.
包被血小板是促凝血血小板，在中风患者中数量升高，且与中风复发相关。在之前的一项研究中，鉴于有数据显示创伤性脑损伤（TBI）后中风风险增加，我们发现与对照组相比，与战斗相关的轻度TBI（mTBI）患者在受伤数年之后包被血小板水平升高。我们现在在更大的患者群体中研究mTBI中通常记录的参数是否与包被血小板潜力增加有关。对120例mTBI患者进行了包被血小板水平检测，检测时间间隔为距上次受伤6个月至10年。计算了包被血小板水平与年龄、性别、种族/民族、意识丧失、意识改变、创伤后遗忘、受伤次数、损伤机制、首次和最后一次受伤后的时间、吸烟、可能影响包被血小板水平的药物以及相关合并症之间的相关性。发现包被血小板水平与受伤次数（p = 0.026）、性别（p = 0.01）和距上次受伤的时间（p = 0.04）之间存在显著相关性。多变量线性模型分析纳入了这三个参数以及另外三个p值<0.2的参数（种族/民族、吸烟和损伤机制），结果显示受伤次数可预测包被血小板水平（p = 0.004）。这些结果支持了mTBI中包被血小板水平升高与反复受伤之间的机制联系。需要进行长期研究以确定mTBI患者血栓形成潜力增加的影响。
