平均血小板体积在急性缺血性脑卒中发病机制中的改变：原因还是结果？

Alteration of mean platelet volume in the pathogenesis of acute ischemic stroke: cause or consequence?

作者信息

Ayas Zeynep Özözen, Can Ufuk

机构信息

Sakarya University Training and Research Hospital, Department of Neurology, Sakarya, Turkey.

Baskent University Faculty of Medicine, Department of Neurology, Ankara, Turkey.

出版信息

Ideggyogy Sz. 2018 Jan 30;71(1-02):49-56. doi: 10.18071/isz.71.0049.

DOI:10.18071/isz.71.0049

PMID:29465900

Abstract

BACKGROUND AND PURPOSE

Platelets have a crucial role on vascular disease which are involved in pathogenesis of ischemic stroke. Platelet size is measured as mean platelet volume (MPV) and is a marker of platelet activity. Platelets contain more dense granules as the size increases and produce more serotonin and tromboglobulin (b-TG) than small platelets. In this study, the alteration of MPV values were investigated in patients with acute stroke, who had MPV values before stroke, during acute ischemic stroke and 7 days after the stroke. The relationship between this alteration and risk factors, etiology and localization of ischemic stroke were also investigated.

METHODS

Sixty-seven patients with clinically and radiologically established diagnoses of ischemic stroke were enrolled into the study and stroke etiology was classified by modified Trial of Org 10 172 in Acute Stroke Treatment (TOAST) classification and, modified Bamford classification was used for localization and stroke risk factors were also evaluated. The platelet counts and MPV values from patient files in patients who had values before stroke (at examination for another diseases), within 24 hours of symptom onset and after 7 further days were analysed.

RESULTS

MPV values increased after stroke (10.59±2.26) compared with acute stroke values (9.84±1.64) and the values before stroke (9.59±1.72) (p<0.0001); this alteration of MPV values occured 7 days after stroke (p<0.016). There was a positive correlation between age and MPV values during acute stroke (r=0.270; p<0.05). Patients with atrial fibrillation had higher alteration in the time of MPV compared with patients without atrial fibrillation (p>0.006). We assessed for gender, men (n=38) had a higher alteration in the time of MPV compared with women (n=29) (p=0.013).

CONCLUSION

Although there was no alteration of platelet counts, MPV values were increased 7 days after stroke in patients with acute ischemic stroke.

摘要

背景与目的

血小板在血管疾病中起关键作用，参与缺血性脑卒中的发病机制。血小板大小通过平均血小板体积（MPV）来衡量，是血小板活性的一个指标。随着血小板尺寸增大，其所含致密颗粒增多，与小血小板相比能产生更多的血清素和血小板球蛋白（β-TG）。在本研究中，对急性脑卒中患者在卒中前、急性缺血性卒中期间及卒中后7天的MPV值变化进行了研究。还探讨了这种变化与缺血性卒中的危险因素、病因及部位之间的关系。

方法

67例经临床和影像学确诊为缺血性卒中的患者纳入本研究，采用改良的急性卒中治疗Org 10172试验（TOAST）分类法对卒中病因进行分类，采用改良的班福德分类法确定部位，并评估卒中危险因素。分析患者病历中卒中前（因其他疾病检查时）、症状发作后24小时内及再过7天后的血小板计数和MPV值。

结果

与急性卒中时的值（9.84±1.64）及卒中前的值（9.59±1.72）相比，卒中后MPV值升高（10.59±2.26）（p<0.0001）；MPV值的这种变化在卒中后7天出现（p<0.016）。急性卒中期间年龄与MPV值呈正相关（r=0.270；p<0.05）。与无房颤的患者相比，房颤患者的MPV值变化更大（p>0.006）。我们评估了性别，男性（n=38）与女性（n=29）相比，MPV值变化更大（p=0.013）。