Dębiec Aleksander, Pogoda-Wesołowska Aleksandra, Piasecki Piotr, Stępień Adam, Staszewski Jacek
Clinic of Neurology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland.
Department of Interventional Radiology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland.
Life (Basel). 2021 May 24;11(6):469. doi: 10.3390/life11060469.
(1) Background: An early diagnosis of a large vessel occlusion (LVO) is crucial in the management of the acute ischemic stroke (AIS). The laboratory predictors of LVO and a stroke outcome remain unknown. We have hypothesized that high MPV-a surrogate marker of the activated platelet-may be associated with LVO, and it may predict a worse AIS outcome. (2) Methods: This was a retrospective study of 361 patients with AIS who were treated with thrombolysis (tPA, 65.7%) and/or mechanical thrombectomy (MT, 34.3%) in a tertiary Stroke Center between 2011 and 2019. (3) Results: The mean MPV in the cohort was 9.86 ± 1.5 fL (1st-4th quartiles: <8.8, >10.80 fL). Patients in the 4th quartile compared to the 1st had a significantly ( < 0.01) more often incidence of an LVO related stroke (75% vs. 39%) and a severe stroke manifestation with a higher RACE score (5.2 ± 2.8 vs. 3.3 ± 2.4), NIHSS at baseline (mean ± SD, 14 ± 6.5 vs. 10.9 ± 5.2), and NIHSS at discharge (6.9 ± 7 vs. 3.9 ± 3.6). A multivariate analysis revealed that quartiles of MPV (OR 1.4; 95%CI 1.2-1.8) significantly predicted an LVO stroke, also after the adjustment for RACE < 5 (OR 1.4; 95%CI 1.08-1.89), but MPV quartiles did not predict a favorable stroke outcome (mRS ≤ 2) (OR 0.89; 95%CI 0.7-1.13). (4) Conclusion: Our data suggest that MPV is an independent predictor of LVO in patients with an acute ischemic stroke.
（1）背景：大血管闭塞（LVO）的早期诊断在急性缺血性卒中（AIS）的治疗中至关重要。LVO和卒中预后的实验室预测指标仍不明确。我们推测，高MPV（活化血小板的替代标志物）可能与LVO相关，并且可能预示AIS预后较差。（2）方法：这是一项对361例AIS患者的回顾性研究，这些患者于2011年至2019年在一家三级卒中中心接受了溶栓治疗（tPA，65.7%）和/或机械取栓治疗（MT，34.3%）。（3）结果：该队列中的平均MPV为9.86±1.5 fL（第一至第四四分位数：<8.8，>10.80 fL）。与第一四分位数的患者相比，第四四分位数的患者发生LVO相关卒中的发生率显著更高（<0.01）（75%对39%），并且有更严重的卒中表现，RACE评分更高（5.2±2.8对3.3±2.4），基线时的美国国立卫生研究院卒中量表（NIHSS）评分（平均值±标准差，14±6.5对10.9±5.2），以及出院时的NIHSS评分（6.9±7对3.9±3.6）。多变量分析显示，MPV四分位数（OR 1.4；95%CI 1.2 - 1.8）显著预测LVO卒中，在对RACE<5进行调整后也是如此（OR 1.4；95%CI 1.08 - 1.89），但MPV四分位数不能预测良好的卒中预后（改良Rankin量表评分≤2）（OR 0.89；95%CI 0.7 - 1.13）。（4）结论：我们的数据表明，MPV是急性缺血性卒中患者LVO的独立预测指标。
