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血小板参数在新生血管性青光眼中的作用:一项中国的回顾性病例对照研究。

Role of Platelet Parameters on Neovascular Glaucoma: A Retrospective Case-Control Study in China.

作者信息

Li Shengjie, Cao Wenjun, Sun Xinghuai

机构信息

Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, China.

Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, China.

出版信息

PLoS One. 2016 Dec 1;11(12):e0166893. doi: 10.1371/journal.pone.0166893. eCollection 2016.

Abstract

PURPOSE

Retinal vein occlusion (RVO) and diabetic retinopathy (DR) are two major sight-threatening diseases which may lead to neovascular glaucoma (NVG). The aim of this study was to explore the association between platelet parameters and NVG.

METHODS

A total of 185 subjects were enrolled for the study from January, 2012 to December, 2015 at the Eye-ENT Hospital of Fudan University. Patients include those with NVG secondary to RVO (RVO group, n = 38), patients with NVG secondary to DR (DR group, n = 47), diabetics mellitus without retinopathy (DM group, n = 52), and healthy individuals (control group, n = 48). A complete ophthalmological examination including visual field examination, A-scan ultrasound, Fundus photography, and measurement of platelet parameters were performed for NVG subjects.

RESULTS

There was no statistical difference in the mean age and gender among the RVO, DR, and control groups (p>0.05). The mean level of platelet distribution width (PDW) was higher (p<0.001) in the RVO group (15.16±2.13fl) and DR group (16.17±1.66fl) when compared with the control group (13.77±2.99fl). The mean plateletcrit (PCT) value of the RVO group (0.229±0.063%) was also higher (p = 0.049) than the control group (0.199±0.045). In the DR group, mean platelet volume (MPV) value (10.72±1.57fl) was significantly higher (p = 0.002) than the control group (9.75±0.89fl). A similar trend was observed when platelet parameters were compared among the 3 groups with respect to age. The mean level of PDW was significantly higher (p<0.001) in the DR group (16.17±1.66fl) compared with the DM group (13.80±3.32fl). Stepwise multiple logistic regression analysis revealed that PDW (OR = 1.44, 95%CI = 1.149-1.805, p = 0.002) and MPV (OR = 1.503, 95%CI = 1.031-2.192, p = 0.034) were associated with the DR group, PDW (OR = 1.207, 95%CI = 1.010-1.443, p = 0.039) and PCT (OR = 1.663, 95%CI = 1.870-2.654, p = 0.036) were associated with the RVO group.

CONCLUSION

Our results suggest that increased PDW and MPV are associated with the NVG secondary to DR group, elevated PDW and PCT are associated with the RVO group. It indicates that platelets might be an important factor in the onset and/or development of NVG.

摘要

目的

视网膜静脉阻塞(RVO)和糖尿病视网膜病变(DR)是两种主要的致盲性疾病,可导致新生血管性青光眼(NVG)。本研究旨在探讨血小板参数与NVG之间的关联。

方法

2012年1月至2015年12月期间,复旦大学附属眼耳鼻喉科医院共纳入185名受试者。患者包括继发于RVO的NVG患者(RVO组,n = 38)、继发于DR的NVG患者(DR组,n = 47)、无视网膜病变的糖尿病患者(DM组,n = 52)和健康个体(对照组,n = 48)。对NVG受试者进行了包括视野检查、A超、眼底照相和血小板参数测量在内的全面眼科检查。

结果

RVO组、DR组和对照组之间的平均年龄和性别无统计学差异(p>0.05)。与对照组(13.77±2.99fl)相比,RVO组(15.16±2.13fl)和DR组(16.17±1.66fl)的血小板分布宽度(PDW)平均水平更高(p<0.001)。RVO组的平均血小板压积(PCT)值(0.229±0.063%)也高于对照组(0.199±0.045)(p = 0.049)。在DR组中,平均血小板体积(MPV)值(10.72±1.57fl)显著高于对照组(9.75±0.89fl)(p = 0.002)。在按年龄比较这3组的血小板参数时,观察到了类似的趋势。与DM组(13.80±3.32fl)相比,DR组的PDW平均水平显著更高(p<0.001)。逐步多元逻辑回归分析显示,PDW(OR = 1.44,95%CI = 1.149 - 1.805,p = 0.002)和MPV(OR = 1.503,95%CI = 1.031 - 2.192,p = 0.034)与DR组相关,PDW(OR = 1.207,95%CI = 1.010 - 1.443,p = 0.039)和PCT(OR = 1.663,95%CI = 1.870 - 2.654,p = 0.036)与RVO组相关。

结论

我们的结果表明,PDW和MPV升高与继发于DR组的NVG相关,PDW和PCT升高与RVO组相关。这表明血小板可能是NVG发病和/或发展的一个重要因素。

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