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急性心肌梗死时及之后的血小板计数和平均血小板体积

Platelet Count and Mean Platelet Volume at the Time of and After Acute Myocardial Infarction.

作者信息

Amraotkar Alok Ravindra, Song David Day, Otero Diana, Trainor Patrick James, Ismail Imtiaz, Kothari Vallari, Singh Ayesha, Moore Joseph B, Rai Shesh Nath, DeFilippis Andrew Paul

机构信息

1 Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA.

2 School of Medicine, University of Louisville, Louisville, KY, USA.

出版信息

Clin Appl Thromb Hemost. 2017 Nov;23(8):1052-1059. doi: 10.1177/1076029616683804. Epub 2016 Dec 21.

Abstract

Platelet count has been shown to be lower and mean platelet volume (MPV) to be higher in acute myocardial infarction (MI). However, it is not known whether these changes persist post-MI or if these measures are able to distinguish between acute thrombotic and non-thrombotic MI. Platelet count and MPV were measured in 80 subjects with acute MI (thrombotic and non-thrombotic) and stable coronary artery disease (CAD) at cardiac catheterization (acute phase) and at >3-month follow-up (quiescent phase). Subjects were stratified using stringent clinical, biochemical, histological, and angiographic criteria. Outcome measures were compared between groups by analysis of variance. Forty-seven subjects met criteria for acute MI with clearly defined thrombotic (n = 22) and non-thrombotic (n = 12) subsets. Fourteen subjects met criteria for stable CAD. No significant difference was observed in platelet count between subjects with acute MI and stable CAD at the acute or quiescent phase. MPV was higher in acute MI (9.18 ± 1.21) compared to stable CAD (8.13 ± 0.66; P = 0.003) at the acute phase but not at the quiescent phase (8.48 ± 0.58 vs 8.94 ± 1.42; P = 0.19). No difference in platelet count or MPV was detected between thrombotic and non-thrombotic subsets at acute or quiescent phases. The power to detect differences in these measures between thrombotic and non-thrombotic subsets was 58%. Higher MPV at the time of acute MI is not observed by 3 months post-MI (quiescent phase). Platelet count and MPV do not differ in subjects with thrombotic versus non-thrombotic MI. Further investigation is warranted to evaluate the utility of these measures in the diagnosis of acute MI.

摘要

血小板计数在急性心肌梗死(MI)中已被证明较低,而平均血小板体积(MPV)较高。然而,尚不清楚这些变化在心肌梗死后是否持续存在,或者这些指标是否能够区分急性血栓性心肌梗死和非血栓性心肌梗死。在80例急性心肌梗死(血栓性和非血栓性)和稳定型冠状动脉疾病(CAD)患者进行心导管检查时(急性期)以及3个月以上随访时(静止期)测量了血小板计数和MPV。根据严格的临床、生化、组织学和血管造影标准对受试者进行分层。通过方差分析比较组间的结果指标。47例受试者符合急性心肌梗死标准,有明确界定的血栓性(n = 22)和非血栓性(n = 12)亚组。14例受试者符合稳定型CAD标准。在急性期或静止期,急性心肌梗死患者和稳定型CAD患者的血小板计数未观察到显著差异。急性期时,急性心肌梗死患者的MPV(9.18±1.21)高于稳定型CAD患者(8.13±0.66;P = 0.003),但在静止期无差异(8.48±0.58对8.94±1.42;P = 0.19)。在急性期或静止期,血栓性和非血栓性亚组之间的血小板计数或MPV未检测到差异。检测血栓性和非血栓性亚组之间这些指标差异的效能为58%。心肌梗死后3个月(静止期)未观察到急性心肌梗死时较高的MPV。血栓性心肌梗死与非血栓性心肌梗死患者的血小板计数和MPV无差异。有必要进一步研究以评估这些指标在急性心肌梗死诊断中的效用。

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