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采用全血血小板聚集仪检测血小板反应性水平与 2 型糖尿病患者糖尿病视网膜病变分期的关系。

Relation Between Platelet Reactivity Levels and Diabetic Retinopathy Stage in Patient with Type 2 Diabetes Mellitus by Using Multiplate Whole Blood Aggregometry.

机构信息

Health and Science University, Ümraniye Training Research and Education Hospital, Eye Clinic, Istanbul, Turkey.

Health Science University Kartal Kosuyolu High Training Research and Education Hospital. Kartal, Istanbul, Turkey.

出版信息

Semin Ophthalmol. 2021 Aug 18;36(5-6):392-399. doi: 10.1080/08820538.2021.1893759. Epub 2021 Mar 23.

Abstract

: To test the hypothesis of a possible association between platelet reactivity and the severity of diabetic retinopathy using Multiplate whole blood aggregometry in type 2 diabetes mellitus patients. : Of 157 patients were divided to three groups based on the severity of diabetic retinopathy (normal, non-proliferative and proliferative [ordinal among group 1-2-3]). Platelet reactivity was measured using arachidonic acid response to the ASPI and ADP platelet test. The association between DR stage and the degree of platelet reactivity (predictor variable) ASPI, ADP, systolic blood pressure, age, hypertension, body mass index (BMI), HbA1c, creatinine, Microalbumin, platelet, triglyceride/HDL and Hscrp variables were evaluated using ordinal logistic regression models (Model 1). The association between DR presence (outcome variable (group 1 vs group 2 and 3)) and the presence of variables was evaluated using binary logistic regression models (Model 2). : A comparison of the laboratory parameters of the three groups revealed that the ASPI, ADP, glucose and HbA1c values were significantly higher in Group-3 than Group-1. ASPI (odds-ratio OR: 1.044[1.021-1.09], < .001], ADP (OR: 1.033[1.010-1.10], : 0.002] and HbA1c (OR: 2.42(1.22, 4.94), < .001) were demonstrated to be associated with stage of DR while the other variables were not. In binary logistic regression (model-2) analysis; ASPI (OR: 1.061[1.031-1.1], < .001], ADP (OR: 1.03(1.01, 1.06), : 0.045] and HbA1c (OR: 4.37 (1.67, 11.36)], : 0.002) were associated with DR while the other variables were not. : Herewith, we demonstrated that higher platelet reactivity measured by multiplate ASPI and ADP was significantly associated with stages of DR. Therefore, these measurements may be useful to predict the severity of DR in the clinical practice of physicians.

摘要

目的

使用多板全血聚集仪检测血小板反应性,以检验 2 型糖尿病患者血小板反应性与糖尿病视网膜病变严重程度之间可能存在关联的假说。

方法

在 157 例患者中,根据糖尿病视网膜病变的严重程度(正常、非增殖期和增殖期[组 1-2-3 中的顺序分组])将其分为三组。使用花生四烯酸对 ASPI 和 ADP 血小板试验的反应来测量血小板反应性。使用有序逻辑回归模型(模型 1)评估 DR 分期与血小板反应性程度(预测变量)ASPI、ADP、收缩压、年龄、高血压、体重指数(BMI)、HbA1c、肌酐、微量白蛋白、血小板、甘油三酯/高密度脂蛋白和 Hscrp 变量之间的关联。使用二元逻辑回归模型(模型 2)评估 DR 存在(结局变量(组 1 与组 2 和 3))与变量存在之间的关联。

结果

三组实验室参数比较显示,组 3 的 ASPI、ADP、血糖和 HbA1c 值明显高于组 1。ASPI(比值比 OR:1.044[1.021-1.09],<0.001])、ADP(OR:1.033[1.010-1.10],0.002])和 HbA1c(OR:2.42[1.22,4.94],<0.001)与 DR 分期相关,而其他变量则不相关。在二元逻辑回归(模型 2)分析中;ASPI(OR:1.061[1.031-1.1],<0.001])、ADP(OR:1.03[1.01,1.06],0.045])和 HbA1c(OR:4.37[1.67,11.36]),<0.001)与 DR 相关,而其他变量则不相关。

结论

在此,我们证明了多板 ASPI 和 ADP 测量的更高血小板反应性与 DR 分期显著相关。因此,这些测量值在医生的临床实践中可能有助于预测 DR 的严重程度。

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