Weymann Alexander, Ali-Hasan-Al-Saegh Sadeq, Sabashnikov Anton, Popov Aron-Frederik, Mirhosseini Seyed Jalil, Nombela-Franco Luis, Testa Luca, Lotfaliani Mohammadreza, Zeriouh Mohamed, Liu Tong, Dehghan Hamidreza, Yavuz Senol, de Oliveira Sá Michel Pompeu Barros, Baker William L, Jang Jae-Sik, Gong Mengqi, Benedetto Umberto, Dohmen Pascal M, D'Ascenzo Fabrizio, Deshmukh Abhishek J, Biondi-Zoccai Giuseppe, Calkins Hugh, Stone Gregg W, Surgery And Cardiology-Group Imcsc-Group Integrated Meta-Analysis Of Cardiac
Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Med Sci Monit Basic Res. 2017 Mar 17;23:58-86. doi: 10.12659/msmbr.902557.
BACKGROUND This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of platelet cellular and functional characteristics including platelet count (PC), MPV, platelet distribution width (PDW), platelet factor 4, beta thromboglobulin (BTG), and p-selectin with the occurrence of atrial fibrillation (AF) and consequent stroke. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating platelet characteristics in patients with paroxysmal, persistent and permanent atrial fibrillations. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity. RESULTS Literature search of all major databases retrieved 1,676 studies. After screening, a total of 73 studies were identified. Pooled analysis showed significant differences in PC (weighted mean difference (WMD)=-26.93 and p<0.001), MPV (WMD=0.61 and p<0.001), PDW (WMD=-0.22 and p=0.002), BTG (WMD=24.69 and p<0.001), PF4 (WMD=4.59 and p<0.001), and p-selectin (WMD=4.90 and p<0.001). CONCLUSIONS Platelets play a critical and precipitating role in the occurrence of AF. Whereas distribution width of platelets as well as factors of platelet activity was significantly greater in AF patients compared to SR patients, platelet count was significantly lower in AF patients.
背景 本项带有荟萃分析的系统评价旨在确定评估血小板细胞和功能特征（包括血小板计数（PC）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板因子4、β-血小板球蛋白（BTG）和p-选择素）与心房颤动（AF）发生及随后中风之间关联的证据强度。
材料与方法 我们对评估阵发性、持续性和永久性心房颤动患者血小板特征的观察性研究进行了荟萃分析。进行了全面的亚组分析以探索异质性的潜在来源。
结果 对所有主要数据库的文献检索共检索到1676项研究。筛选后，共确定了73项研究。汇总分析显示，在PC（加权平均差（WMD）=-26.93，p<0.001）、MPV（WMD=0.61，p<0.001）、PDW（WMD=-0.22，p=0.002）、BTG（WMD=24.69，p<0.001）、PF4（WMD=4.59，p<0.001）和p-选择素（WMD=4.90，p<0.001）方面存在显著差异。
结论 血小板在AF的发生中起关键的促发作用。与窦性心律（SR）患者相比，AF患者的血小板分布宽度以及血小板活性因子明显更高，而AF患者的血小板计数明显更低。
