Perek Bartłomiej, Rzymski Piotr, Komosa Anna, Olasińska-Wiśniewska Anna, Puślecki Mateusz, Jemielity Marek, Lesiak Maciej, Aboul-Hassan Sleiman Sebastian, Stankowski Tomasz, Xia Zhengyuan, Stelmark Konrad, Siller-Matula Jolanta, Poniedziałek Barbara
Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Cardiol J. 2021 Nov 17;30(6):995-1002. doi: 10.5603/CJ.a2021.0150.
Excessive metabolic excitation of platelets after cardiac procedures may be related to some adverse events but assessment of their metabolic activity is not routine. The purpose of this study was to evaluate which of the basic platelet morphological parameters best reflects their metabolic status.
The blood samples of 22cardiac surgical patients (mean age of 62.3 ± 10.3 years) were taken before surgery (BS), and 1, 24 and 48 hours after the operation. Correlations between morphological platelet parameters (platelet count [PLT], mean platelet volume [MPV], platelet distribution width [PDW] and MPV/PLT) and their metabolic activity (total concentration of malondialdehyde [MDA] and MDA/PLT) were estimated.
Significant decline in PLT after operation (from 223 ± 44 × 10¹²/L to 166 ± 57 × 10¹²/L) was accompanied by marked increase in MPV (from 8.4 ± 0.9 fL to 9.1 ± 1.2 fL) and no change of PDW. Consequently, MPV/PLT index increased significantly after procedures from (median with IQR) 0.038 (0.030-0.043) to 0.053 (0.043-0.078). Simultaneously, a significant increase in total platelet MDA content and MDA/PLT was noted reaching peak levels soon after operation. The strongest correlation was observed between MPV/PLT and MDA/PLT (r = 0.56; p < 0.001), although the others were also found to be significant (MDA/PLT vs. MPV; r = 0.35; MDA/PLT vs. PDW; r = 0.34).
Among basic morphological parameters and indices, the MPV-to-PLT ratio reflects the best metabolic status of platelets in cardiac surgical patients.
心脏手术后血小板过度的代谢兴奋可能与一些不良事件有关，但对其代谢活性的评估并非常规操作。本研究的目的是评估哪些基本血小板形态学参数最能反映其代谢状态。
采集22例心脏手术患者（平均年龄62.3±10.3岁）术前（BS）及术后1、24和48小时的血样。评估血小板形态学参数（血小板计数[PLT]、平均血小板体积[MPV]、血小板分布宽度[PDW]和MPV/PLT）与其代谢活性（丙二醛[MDA]总浓度和MDA/PLT）之间的相关性。
术后PLT显著下降（从223±44×10¹²/L降至166±57×10¹²/L），同时MPV显著增加（从8.4±0.9 fL增至9.1±1.2 fL），PDW无变化。因此，术后MPV/PLT指数从（中位数及四分位间距）0.038（0.030 - 0.043）显著增至0.053（0.043 - 0.078）。同时，血小板MDA总含量和MDA/PLT显著增加，术后不久达到峰值水平。尽管其他参数之间的相关性也显著（MDA/PLT与MPV；r = （0.35）；MDA/PLT与PDW；r = 0.34），但MPV/PLT与MDA/PLT之间的相关性最强（r = 0.56；p < 0.001）。
在基本形态学参数和指标中，MPV与PLT的比值最能反映心脏手术患者血小板的代谢状态。
