Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, China.
Department of Neurology, Zhongshan Hospital Xiamen University, Xiamen, China.
J Neurointerv Surg. 2018 Jan;10(1):25-28. doi: 10.1136/neurintsurg-2016-012849. Epub 2017 Jan 12.
Elevated mean platelet volume (MPV), indicating higher platelet activity, could be a predictor of prognosis in patients with acute ischemic stroke receiving medical therapy.
To investigate the relationship between MPV and functional outcome in patients with acute anterior circulation stroke 3 months after undergoing mechanical thrombectomy (MT).
A total of 153 consecutive patients with acute stroke following MT, in two separate stroke centers, were enrolled between May 2013 and March 2016. MPV was measured on admission. Subjects were divided into two groups according to average MPV level. Univariate and multivariate analyses were performed. MPV was also incorporated into the Houston IA Therapy (HIAT) score, which was developed as a scoring system to predict poor prognosis, and the prediction capability was compared with the HIAT score alone.
The average MPV was 10.4 fL. Patients with high MPV had a significantly lower rate of functional independence (28.9% vs 57.1%, p=0.000). After multivariable analysis, elevated MPV remained an independent predictor of unfavorable outcome (OR=3.93, 95% CI 1.73 to 8.94, p=0.001). When the MPV cut-off value was set at 10.4 fL using the receiver operating characteristic (ROC) analysis, MPV ≥10.4 fL predicted unfavorable outcome with 62.1% sensitivity and 66.7% specificity, respectively. Addition of MPV to the HIAT score did not improve predictive power compared with the HIAT score system alone by a comparison of the areas under the two ROC curves (0.70 vs 0.62, p=0.174).
Elevated MPV is an independent predictor of poor outcome in patients with acute anterior circulation stroke undergoing MT at 3 months.
血小板平均体积（MPV）升高表明血小板活性增高，可能是接受药物治疗的急性缺血性脑卒中患者预后的预测指标。
探讨机械取栓后 3 个月急性前循环卒中患者的平均血小板体积（MPV）与功能结局的关系。
本研究纳入了 2013 年 5 月至 2016 年 3 月在两个独立的卒中中心接受机械取栓治疗的 153 例连续急性卒中患者。入院时测定了 MPV。根据平均 MPV 水平将患者分为两组。进行单因素和多因素分析。MPV 也被纳入为开发的预测预后不良的评分系统——休斯顿 IA 治疗（HIAT）评分，将其与 HIAT 评分进行比较。
平均 MPV 为 10.4 fL。MPV 升高的患者功能独立性的比例显著较低（28.9% vs 57.1%，p=0.000）。多变量分析后，MPV 升高仍然是不良结局的独立预测因子（OR=3.93，95%CI 1.73 至 8.94，p=0.001）。使用受试者工作特征（ROC）分析，当 MPV 截断值设为 10.4 fL 时，MPV≥10.4 fL 预测不良结局的敏感性和特异性分别为 62.1%和 66.7%。与 HIAT 评分系统相比，将 MPV 加入 HIAT 评分并未提高预测能力，ROC 曲线下面积的比较结果为 0.70 与 0.62（p=0.174）。
在接受机械取栓治疗的急性前循环卒中患者中，MPV 升高是 3 个月预后不良的独立预测指标。
