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平均血小板体积和血小板压积作为急性缺血性卒中短期预后的预测指标。

The mean platelet volume and plateletcrit as predictors of short-term outcome of acute ischemic stroke.

作者信息

Mohamed Al-Amir Bassiouny, Elnady Hassan Mohamed, Alhewaig Hazem Kamal, Moslem Hefny Hesham, Khodery Ashraf

机构信息

1Department of Neurology and Psychological Medicine, Faculty of Medicine, Sohag University Hospital, Sohag, Egypt.

2Department of Clinical Pathology, Faculty of Medicine, Sohag University Hospital, Sohag, Egypt.

出版信息

Egypt J Neurol Psychiatr Neurosurg. 2019;55(1):4. doi: 10.1186/s41983-018-0035-x. Epub 2019 Jan 8.

Abstract

BACKGROUND

Activation of the platelet plays an important role in the process of atherosclerosis. Mean platelet volume (MPV) is significantly associated with the poor outcome of acute ischemic stroke while the results of studies about the relationship between plateletcrit (PCT) and stroke outcome were inconsistent. The aim of this work is to determine whether an association exists between MPV and plateletcrit (PCT) and outcome of acute ischemic stroke.

METHODS

We examined 157 patients with ischemic stroke, admitted to the Sohag University Hospital. The diagnosis of stroke was performed clinically according to The World Health Organization and confirmed by brain CT and MRI when needed. Platelet indices including MPV and PCT were assessed immediately (within 2 h) after admission. After 3 months, the functional outcome was assessed using the modified Rankin Scale (mRS) with assessment of the relationship between platelet indices and stroke outcome.

RESULTS

About 50% of the participants have favorable outcome. MPV was significantly higher in the unfavorable group (10.4 ± 2.3 fL) than in the favorable one (8.7 ± 1.3 fL) ( < 0. 001). MPV was an independent predictor of poor short-term outcome of acute stroke after controlling for confounders like diabetes mellitus. The mean PCT was significantly higher in the unfavorable group (0.28 ± 0.1%) than in the favorable one (0.25 ± 0.1%) ( = 0. 04) but not considered as an independent predictor of poor short-term outcome of acute stroke.

CONCLUSIONS

MPV and PCT were significantly correlated with poor functional outcome, only MPV was an independent predictor of poor short-term outcome of acute stroke after controlling for confounders like DM, and these platelet indices can be used as a prognostic tool.

摘要

背景

血小板的激活在动脉粥样硬化过程中起重要作用。平均血小板体积(MPV)与急性缺血性卒中的不良预后显著相关,而关于血小板压积(PCT)与卒中预后关系的研究结果并不一致。本研究旨在确定MPV、血小板压积(PCT)与急性缺血性卒中预后之间是否存在关联。

方法

我们对157例入住索哈格大学医院的缺血性卒中患者进行了检查。根据世界卫生组织的标准对卒中进行临床诊断,必要时通过脑部CT和MRI进行确诊。入院后立即(2小时内)评估包括MPV和PCT在内的血小板指标。3个月后,使用改良Rankin量表(mRS)评估功能预后,并评估血小板指标与卒中预后之间的关系。

结果

约50%的参与者预后良好。不良预后组的MPV(10.4±2.3fL)显著高于预后良好组(8.7±1.3fL)(P<0.001)。在控制了糖尿病等混杂因素后,MPV是急性卒中短期不良预后的独立预测因素。不良预后组的平均PCT(0.28±0.1%)显著高于预后良好组(0.25±0.1%)(P=0.04),但未被视为急性卒中短期不良预后的独立预测因素。

结论

MPV和PCT与功能不良预后显著相关,仅MPV在控制了糖尿病等混杂因素后是急性卒中短期不良预后的独立预测因素,这些血小板指标可作为一种预后工具。

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