Lippi Giuseppe, Buonocore Ruggero, Cervellin Gianfranco
Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy.
Semin Thromb Hemost. 2016 Sep;42(6):632-5. doi: 10.1055/s-0036-1571335. Epub 2016 Apr 13.
Platelets are small corpuscular elements, which play an essential role in hemostasis and thrombosis. As active players in the thrombotic process, hyperactive platelets are involved in the pathogenesis of cardiovascular disorders. Nevertheless, the role of platelet size, as a biological marker of platelet activation, remains debated in the setting of venous thrombosis. Therefore, we conducted a retrospective case-control study to clarify the potential association between mean platelet volume (MPV) and newly diagnosed venous thromboembolism (VTE) by reviewing data of all consecutive patients receiving a diagnosis of VTE at the emergency department (ED) of the University Hospital of Parma (Italy) between January and December, 2014. The control population was represented by outpatients undergoing routine laboratory testing for health checkup at the phlebotomy center of the same University Hospital during the same period. MPV was found to be comparatively decreased in the entire cohort of patients with VTE compared with the outpatient population, as well as in those with isolated deep vein thrombosis (DVT) or pulmonary embolism (PE). A decreased MPV value (i.e., < 10.8 fL) was found to be associated with an increased risk of diagnosing VTE (relative risk, 1.18; 95% CI, 1.09-1.28; p < 0.001), as well as of diagnosing isolated DVT (relative risk, 1.19; 95% CI, 1.07-1.31; p = 0.001) and isolated PE (relative risk, 1.17; 95% CI, 1.04-1.30; p = 0.007). A decreased MPV value in active cancer patients was associated with the highest risk of diagnosing thrombosis (relative risk, 1.29; 95% CI, 1.10-1.51; p = 0.002). These results support an inverse association between MPV and the risk of venous thrombosis at diagnosis.
血小板是微小的细胞成分，在止血和血栓形成过程中发挥着重要作用。作为血栓形成过程中的活跃参与者，血小板功能亢进与心血管疾病的发病机制有关。然而，在静脉血栓形成的情况下，血小板大小作为血小板活化的生物学标志物的作用仍存在争议。因此，我们进行了一项回顾性病例对照研究，通过回顾2014年1月至12月期间在意大利帕尔马大学医院急诊科接受静脉血栓栓塞症（VTE）诊断的所有连续患者的数据，以阐明平均血小板体积（MPV）与新诊断的VTE之间的潜在关联。对照组为同期在同一大学医院静脉采血中心接受健康检查常规实验室检测的门诊患者。与门诊患者相比，在整个VTE患者队列中，以及在孤立性深静脉血栓形成（DVT）或肺栓塞（PE）患者中，MPV均相对降低。MPV值降低（即<10.8 fL）与诊断VTE的风险增加相关（相对风险，1.18；95%置信区间，1.09 - 1.28；p<0.001），以及诊断孤立性DVT（相对风险，1.19；95%置信区间，1.07 - 1.31；p = 0.001）和孤立性PE（相对风险，1.17；95%置信区间，1.04 - 1.30；p = 0.007）的风险增加相关。活跃癌症患者中MPV值降低与诊断血栓形成的风险最高相关（相对风险，1.29；95%置信区间，1.10 - 1.51；p = 0.002）。这些结果支持了MPV与诊断时静脉血栓形成风险之间的负相关关系。
