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高脂血症与血小板参数:同一硬币的两面

Hyperlipidemia and Platelet Parameters: Two Sides of the Same Coin.

作者信息

Singh Anurag, Singh Anupam, Kushwaha Rashmi, Yadav Geeta, Tripathi Tanya, Chaudhary S C, Verma Shailendra P, Singh Uma S

机构信息

Pathology, King George's Medical University, Lucknow, IND.

Heamatopathology, King George's Medical University, Lucknow, IND.

出版信息

Cureus. 2022 Jun 12;14(6):e25884. doi: 10.7759/cureus.25884. eCollection 2022 Jun.

Abstract

INTRODUCTION

Hyperlipidemia is a disorder in which lipid and cholesterol levels in the blood are elevated. Diabetes, coronary heart disease, obesity, and hypertension are commonly linked to hyperlipidemia. Despite this, hyperlipidemia is a widely neglected illness, owing to its asymptomatic nature, ignorance of aberrant lipid profiles on screening, and economic issues in poor countries such as India. Platelets have been shown to have a role in the thrombus consequences of atheromatous damage in hyperlipidemic individuals by initiating and propagating atherosclerotic plaques. Platelets with bigger diameters are thought to be more metabolically, enzymatically, and functionally agile than platelets with lower sizes. In steady-state operation, these bigger platelets release more thromboxane B2 than regular platelets. Platelets with bigger sizes are more hemostatically active and hence have a higher chance of forming a thrombus and thromboembolism. The aim of this study was to compare the values of key platelet parameters and platelet function in hyperlipidemic patients with normal age and sex-matched controls.

MATERIAL AND METHODS

A total of 100 individuals were included in this study, with 68 cases of hyperlipidemia and 32 controls having normal lipid profiles. Platelet volume indices (PVI) such as platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), plateletcrit (PCT), and platelet function (platelet aggregation with adenosine diphosphate, ADP) were compared between hyperlipidemia patients and age sex-matched controls with normal lipid profiles.

RESULTS

The cases had a statistically significant higher mean MPV (10.55 ± 1.81), PDW (14.93 ± 2.82), and P-LCR (30.97 ± 11.74) compared to mean MPV (9.35 ± 1.85), PDW (13.10 ± 2.60), and P-LCR (25.13 ± 12.23) of controls (p-value < 0.05). No significant difference was observed between the study group and control group with respect to mean PC and PCT (p-value > 0.05). In this study, there was a statistically significant increase noted in platelet aggregation percentage in hyperlipidemic patients than in the control group (42.03 ± 25.28 vs 31.25 ± 15.11) (p-value < 0.05).

CONCLUSION

To conclude, platelet parameters are a significant, easy, and cost-effective method for predicting future acute episodes in hyperlipidemic patients that should be utilized more widely. To avoid vascular events, these individuals may require higher antiplatelet dosages and more rigorous hyperlipidemia therapy.

摘要

引言

高脂血症是一种血液中脂质和胆固醇水平升高的病症。糖尿病、冠心病、肥胖症和高血压通常与高脂血症有关。尽管如此,由于其无症状的性质、筛查时对异常血脂谱的忽视以及印度等贫穷国家的经济问题,高脂血症仍是一种被广泛忽视的疾病。血小板已被证明通过启动和传播动脉粥样硬化斑块,在高脂血症患者动脉粥样硬化损伤的血栓形成后果中发挥作用。直径较大的血小板被认为比尺寸较小的血小板在代谢、酶活性和功能上更活跃。在稳态运行中,这些较大的血小板比正常血小板释放更多的血栓素B2。尺寸较大的血小板具有更高的止血活性,因此形成血栓和血栓栓塞的可能性更高。本研究的目的是比较年龄和性别匹配的高脂血症患者与正常对照者的关键血小板参数值和血小板功能。

材料与方法

本研究共纳入100名个体,其中68例高脂血症患者和32例血脂正常的对照者。比较了高脂血症患者与年龄和性别匹配的血脂正常对照者的血小板体积指数(PVI),如血小板计数(PC)、平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板大细胞比率(P-LCR)、血小板压积(PCT)以及血小板功能(二磷酸腺苷诱导的血小板聚集)。

结果

与对照组的平均MPV(9.35±1.85)、PDW(13.10±2.60)和P-LCR(25.13±12.23)相比,病例组的平均MPV(10.55±1.81)、PDW(14.93±2.82)和P-LCR(30.97±11.74)具有统计学显著差异(p值<0.05)。研究组与对照组在平均PC和PCT方面未观察到显著差异(p值>0.05)。在本研究中,高脂血症患者的血小板聚集百分比相比对照组有统计学显著升高(42.03±25.28对vs 31.25±15.11)(p值<0.05)。

结论

总之,血小板参数是预测高脂血症患者未来急性发作的一种重要、简便且经济有效的方法,应更广泛地应用。为避免血管事件,这些个体可能需要更高剂量的抗血小板药物和更严格的高脂血症治疗。

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