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急性缺血性卒中患者平均血小板体积与危险因素及功能转归的相关性

Association of Mean Platelet Volume with Risk Factors and Functional Outcome in Acute Ischemic Stroke.

作者信息

Ot Sreejith, Zafar Lubna, Beg Mujahid, Siddiqui Obaid Ahmed

机构信息

Department of Medicine, Jawaharlal Nehru Medical College Hospital, Aligarh, Uttar Pradesh, India.

Department of Anaesthesiology and Critical Care, Jawaharlal Nehru Medical College Hospital, Aligarh, Uttar Pradesh, India.

出版信息

J Neurosci Rural Pract. 2021 Sep 28;12(4):764-769. doi: 10.1055/s-0041-1735326. eCollection 2021 Oct.

Abstract

Stroke is the second leading cause of death in the world and a major cause of disability, with ischemic stroke contributing to 87% of all strokes. Platelets are central in the formation of thrombus, and in the process, they enlarge in size, become active, and secrete prothrombotic factors. This is supported by the presence of large platelets in ischemic stroke, where they may be implicated in the pathogenesis of vessel occlusion, leading to stroke. The mean platelet volume (MPV) is an important laboratory marker of platelet function and activation.  The present study was conducted to assess the role of MPV in the pathogenesis, severity, and outcome of ischemic stroke. It was an observational study in 100 acute ischemic stroke (AIS) patients (excluding cardioembolic stroke) admitted to the Medicine wards, Department of Medicine, Jawaharlal Nehru Medical College, a tertiary care hospital at Aligarh. The MPV was correlated with the conventional risk factors of ischemic stroke and outcome (using modified Rankin scale [mRS]). The study revealed statistically significant correlation between MPV and hypertension, type 2 diabetes mellitus, and carotid intima media thickness (CIMT). Also, the MPV at presentation positively correlated with mRS (correlation coefficient 0.818); thus, high MPV was associated with more severe disability.  The MPV at the time of presentation of ischemic stroke may be useful in predicting the severity of stroke and neurological recovery. However, a larger study including diverse population is required to endorse its predictive value in AIS.

摘要

中风是全球第二大致死原因和主要致残原因,缺血性中风占所有中风的87%。血小板在血栓形成过程中起核心作用,在此过程中,它们体积增大、变得活跃并分泌促血栓形成因子。缺血性中风中存在大血小板支持了这一观点,大血小板可能与血管闭塞的发病机制有关,进而导致中风。平均血小板体积(MPV)是血小板功能和活化的重要实验室指标。

本研究旨在评估MPV在缺血性中风的发病机制、严重程度和预后中的作用。这是一项对100例急性缺血性中风(AIS)患者(不包括心源性栓塞性中风)进行的观察性研究,这些患者入住位于阿里格尔的三级护理医院贾瓦哈拉尔·尼赫鲁医学院内科病房。将MPV与缺血性中风的传统危险因素及预后(采用改良Rankin量表[mRS])进行相关性分析。研究显示,MPV与高血压、2型糖尿病和颈动脉内膜中层厚度(CIMT)之间存在统计学上的显著相关性。此外,就诊时的MPV与mRS呈正相关(相关系数为0.818);因此,高MPV与更严重的残疾相关。

缺血性中风就诊时的MPV可能有助于预测中风的严重程度和神经功能恢复情况。然而,需要一项纳入更多样化人群的更大规模研究来证实其在AIS中的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3864/8558973/cd3d94bf41a7/10-1055-s-0041-1735326-i2151492-1.jpg

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