Geng Z Y, Xu X D, Wang Q H, Jiang Q, Lin Y H, Jia C Y, Wu T C, He M A
Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Sep 10;42(9):1580-1585. doi: 10.3760/cma.j.cn112338-20210320-00235.
To explore the associations of platelet parameters platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) with the risk for stroke in people with different blood pressure levels. All the participants were from Dongfeng-Tongji cohort, including 38 295 retired employees from Dongfeng Motor Corporation at the first follow-up survey. After excluding participants with coronary heart disease, stroke, cancer, history of platelet influential drug use and those with missed data of platelet parameters or blood pressure or lost to follow-up, finally a total of 21 294 participants were included in this study. All the participants completed baseline questionnaires, physical examinations, clinical biochemical tests, and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios (s) and the corresponding 95% confident intervals (s) for the associations between platelet parameters and risk for stroke in people with different blood pressure levels. After a mean follow-up of 8.0 years, 1 578 participants developed incident stroke [1 266 ischemic stroke (IS) cases and 312 hemorrhagic stroke (HS) cases]. Compared with the participants with PLT<188×10/L, those with PLT≥188×10/L among hypertension cases were significantly associated with higher risks for stroke and IS (stroke: =1.27, 95%: 1.12-1.44; IS: =1.39, 95%: 1.21-1.60). Among hypertension group, compared with participants with PCT<0.165%, PCT≥0.165% were significantly associated with higher risk for stroke (=1.15, 95%: 1.01-1.30) and lower risk for HS (=0.70, 95%: 0.53-0.93); Among non-hypertension and hypertension group, PCT ≥0.165% were significantly associated with higher risks of IS (=1.27, 95%: 1.05-1.54; =1.31, 95%: 1.14-1.50). MPV and PDW were not significantly associated with risk for stroke. Risk for stroke increased significantly in hypertension cases with different platelet parameters levels compared with non-hypertension cases with lower levels of each platelet parameters. Higher levels of PLT and PCT could increase the risks for stroke and IS in middle-aged and elderly hypertension patients, and lower levels of PCT could decrease the risk for HS in hypertension patients.
探讨血小板参数血小板计数（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）和血小板压积（PCT）与不同血压水平人群中风风险的相关性。所有参与者均来自东风-同济队列，包括在首次随访调查时东风汽车公司的38295名退休员工。在排除患有冠心病、中风、癌症、有血小板影响药物使用史以及血小板参数、血压数据缺失或失访的参与者后，最终共有21294名参与者纳入本研究。所有参与者均完成了基线问卷调查、体格检查、临床生化检测和血样采集。采用Cox比例风险模型估计不同血压水平人群中血小板参数与中风风险之间关联的风险比及其相应的95%置信区间。经过平均8.0年的随访，1578名参与者发生了新发中风[1266例缺血性中风（IS）和312例出血性中风（HS）]。与PLT<188×10⁹/L的参与者相比，高血压病例中PLT≥188×10⁹/L的参与者中风和IS风险显著更高（中风：HR = 1.27，95%CI：1.12 - 1.44；IS：HR = 1.39，95%CI：1.21 - 1.60）。在高血压组中，与PCT<0.165%的参与者相比，PCT≥0.165%与中风风险显著升高（HR = 1.15，95%CI：1.01 - 1.30）和HS风险降低（HR = 0.70，95%CI：0.53 - 0.93）相关；在非高血压组和高血压组中，PCT≥0.165%与IS风险显著升高相关（HR = 1.27，95%CI：（此处原文缺失一个值） - 1.54；HR = 1.31，95%CI：1.14 - 1.50）。MPV和PDW与中风风险无显著关联。与各血小板参数水平较低的非高血压病例相比，不同血小板参数水平的高血压病例中风风险显著增加。较高水平的PLT和PCT可增加中老年高血压患者中风和IS的风险，而较低水平的PCT可降低高血压患者HS的风险。
