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合并非瓣膜性心房颤动的急性缺血性卒中患者的平均血小板体积

Mean Platelet Volume in Patients with Acute Ischemic Stroke with Nonvalvular Atrial Fibrillation.

作者信息

Gul Sidika S, Gozke Eren

出版信息

Clin Lab. 2018 Oct 31;64(11). doi: 10.7754/Clin.Lab.2018.180543.

Abstract

Platelets play an important role in the pathogenesis of vascular disease, and the size of the platelets can determine their reactivity. Large platelets secrete more prothrombotic factors and aggregate more quickly. In this study, we aimed to investigate mean platelet volume (MPV) levels, which are considered to be an indication of the increase in platelet function in previous studies, in cases of acute ischemic stroke (AIS) with nonvalvular atrial fibrillation (NVAF). At Fatih Sultan Mehmet Training and Research Hospital, 297 patients diagnosed with acute ischemic stroke were included in the study and two groups were assigned as patients with and without NVAF. In the study, the relationship between MPV and platelet counts in the first 24 hours after the onset of the symptom between the two groups was examined. In addition, the relationship between MPV and hypertension, diabetes, coronary artery disease, smoking and alcohol use, infarct location, and use of antiplatelet or anticoagulant was assessed. MPV levels were significantly higher in acute ischemic stroke patients with NVAF (p = 0.001; p < 0.01). The mean MPV level in patients with NVAF and non-smokers was significantly higher than smokers (p = 0.012; p < 0.05), but there was no significant relationship between MPV and other parameters. In this study, it was shown that MPV levels were significantly higher in patients with acute ischemic stroke and NVAF than those without NVAF. This finding suggested that MPV which shows platelet reactivity can be assumed as a risk factor of AIS in patients with NVAF.

摘要

血小板在血管疾病的发病机制中起重要作用,血小板的大小可决定其反应性。大血小板分泌更多促血栓形成因子且聚集更快。在本研究中,我们旨在调查平均血小板体积(MPV)水平,在先前研究中,该指标被认为是血小板功能增强的一个指标,此次研究对象为伴有非瓣膜性心房颤动(NVAF)的急性缺血性卒中(AIS)患者。在法提赫·苏丹·穆罕默德培训与研究医院,297例被诊断为急性缺血性卒中的患者被纳入研究,并分为伴有和不伴有NVAF两组。在研究中,检测了两组患者症状发作后最初24小时内MPV与血小板计数之间的关系。此外,还评估了MPV与高血压、糖尿病、冠状动脉疾病、吸烟和饮酒、梗死部位以及抗血小板或抗凝药物使用之间的关系。伴有NVAF的急性缺血性卒中患者的MPV水平显著更高(p = 0.001;p < 0.01)。伴有NVAF的非吸烟者的平均MPV水平显著高于吸烟者(p = 0.012;p < 0.05),但MPV与其他参数之间无显著关系。在本研究中,结果显示伴有急性缺血性卒中和NVAF的患者的MPV水平显著高于不伴有NVAF的患者。这一发现表明,显示血小板反应性的MPV可被视为NVAF患者发生AIS的一个危险因素。

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