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评价 Behcet 病患者的平均血小板体积作为血管血栓形成的指标。

Evaluation of Mean Platelet Volume in Patients With Behcet's Disease as an Indicator of Vascular Thrombosis.

机构信息

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Dermatology, Ankara, Turkey.

出版信息

Arch Iran Med. 2018 Jun 1;21(6):234-239.

Abstract

BACKGROUND

Patients with Behcet's disease (BD) are recognized with increased risk for venous and/or arterial thrombosis. Thrombotic tendency of BD is not known. Vascular injury, loss and dysfunction/hyperfunction of endothelial cells are believed to play a role in thrombosis development. Injury and inflammation due to vasculitis can cause platelet response with increase in mean platelet volume (MPV) and thrombosis in BD. In this study, we aimed to compare the levels of MPV between patients with BD and healthy controls, and also show its effect on thrombosis.

METHODS

One hundred patients with BD and 100 healthy controls were evaluated for MPV levels with clinical findings in age-gender matched case-control study. The variables of patients and controls were compared and correlated using chi-square, Mann-Whitney U and Spearman tests. Logistic regression analysis was used to determine independent predictors of vascular involvement and thrombosis.

RESULTS

Mean MPV was significantly higher in patients with BD than healthy controls (MPV; Patients: 9.2 ± 0.9 [7.3-12.9] vs. Controls: 8.2 ± 0.6 [6.8-10.6] fl; P<0.0001). Platelets levels were lower than controls, but not significantly (236 ± 52.3 [112-451] vs. 245 ± 52.8 [141-467] x10 /L, P=0.55). Negative correlation was found between platelet count and MPV in patients (r = -0.51, P=0.01). Presence of erythema nodosum (EN) and MPV were determined as predictors for vascular involvement and thrombosis (EN: P<0.0001, OR [95% CI] = 35.4 [6.3-178.2]; MPV: P<0.0001, OR [95% CI] = 12.8 [4.1-24.3]).

CONCLUSION

MPV is a simple measurement for indirect monitoring of platelet activity and thrombotic potential. MPV and EN may be independent risk factors for vascular thrombosis in BD. Patients with higher MPV levels and EN in BD, might have been pursued closely for enhancing thrombosis. We advise to check the MPV and put the patients on anticoagulation if it is high.

摘要

背景

白塞病(BD)患者的静脉和/或动脉血栓形成风险增加。BD 的血栓倾向尚不清楚。血管损伤、内皮细胞的丧失和功能/功能亢进被认为在血栓形成发展中起作用。由于血管炎引起的损伤和炎症会导致血小板反应,导致平均血小板体积(MPV)增加,并导致 BD 发生血栓形成。在这项研究中,我们旨在比较 BD 患者和健康对照组之间的 MPV 水平,并显示其对血栓形成的影响。

方法

在年龄和性别匹配的病例对照研究中,评估了 100 例 BD 患者和 100 例健康对照组的 MPV 水平。使用卡方检验、Mann-Whitney U 检验和 Spearman 检验比较患者和对照组的变量,并进行相关性分析。使用逻辑回归分析确定血管受累和血栓形成的独立预测因子。

结果

BD 患者的平均 MPV 明显高于健康对照组(MPV;患者:9.2±0.9[7.3-12.9]vs.对照组:8.2±0.6[6.8-10.6]fl;P<0.0001)。血小板水平低于对照组,但无统计学意义(236±52.3[112-451]vs.245±52.8[141-467]x10/L,P=0.55)。患者中血小板计数与 MPV 呈负相关(r=-0.51,P=0.01)。结节性红斑(EN)和 MPV 被确定为血管受累和血栓形成的预测因子(EN:P<0.0001,OR[95%CI]=35.4[6.3-178.2];MPV:P<0.0001,OR[95%CI]=12.8[4.1-24.3])。

结论

MPV 是间接监测血小板活性和血栓形成倾向的简单测量方法。MPV 和 EN 可能是 BD 血管血栓形成的独立危险因素。BD 中 MPV 水平较高和出现 EN 的患者,可能需要密切监测以增强血栓形成。我们建议检查 MPV,如果它高,就给患者抗凝。

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