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血小板指标作为缺血性脑卒中的预后标志物及其与血脂谱的相关性。

Platelet indices as prognostic markers of ischemic stroke and their correlation with lipid profile.

机构信息

Department of General Medicine, SRM Medical college Hospital and Research Centre, SRMIST, Kattankulathur, Tamil Nadu 603209, India.

Department of Medical Research, SRM Medical college Hospital and Research Centre, SRMIST, Kattankulathur, Tamil Nadu 603209, India.

出版信息

Clin Neurol Neurosurg. 2024 Feb;237:108119. doi: 10.1016/j.clineuro.2024.108119. Epub 2024 Jan 15.

Abstract

OBJECTIVE

Stroke is the cause of one in eight deaths and adds a dreadful burden of disability for the patients. Ischemic stroke is caused by a loss of blood supply to brain due to sudden occlusion of the arterial system, caused by an emboli or thrombus. Our aim was to correlate platelet indices, total cholesterol ratio, and various comorbidities with stroke.

METHODS

A cross-sectional study was performed from 2020-2022 with 132 stroke patients admitted to the SRM Medical College Hospital and Research Center, India. Detailed clinical examination was performed. Venous blood samples were drawn at the time of admission to estimate platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and platelet crit (PCT). Overnight fasting serum samples were obtained for lipid profiling.

RESULTS

Among the participants in our study, maximum belonged to the age group 50 to 59 years (34.1%) and majority were males (79.5%). In terms of comorbidities, 85.6% of the participants had diabetes, 42.4% had hypertension and 22% had dyslipaedemia. All platelet and lipid parameters were found to be similar between patients with and without comorbidities. While all platelet indices increased with the increase in severity of stroke, we found that PDW is most reliable in predicting stroke with an area under the receiver operator curve of 0.942, with a sensitivity and specificity of 92.1% at cut-off value 14. All platelet parameters also significantly increased in patients with severe lipid dysfuction, establishing a correlation between lipid profile, platelet indices and stroke.

CONCULSION

We found a significant relationship between all platelet parameters and stroke. Thus, we believe that patients with risk factors for atherosclerosis should have their platelet indices assessed periodically before the development of cerebrovascular events. Furthermore, dyslipidemia if properly treated, is a modifiable risk factor for stroke, which can decrease morbidity and mortality leading to a healthier society.

摘要

目的

中风是导致八分之一的人死亡的原因之一,会给患者带来严重的残疾负担。缺血性中风是由于动脉系统突然阻塞导致脑供血不足引起的,阻塞的原因是栓塞或血栓。我们的目的是将血小板指数、总胆固醇比值和各种合并症与中风联系起来。

方法

这是一项在 2020 年至 2022 年期间进行的横断面研究,共有 132 名中风患者入住印度 SRM 医学院医院和研究中心。进行了详细的临床检查。在入院时抽取静脉血样以估计血小板计数、平均血小板体积 (MPV)、血小板分布宽度 (PDW) 和血小板crit (PCT)。采集隔夜空腹血清样本进行血脂分析。

结果

在我们的研究参与者中,最大的年龄组是 50 至 59 岁(34.1%),大多数是男性(79.5%)。就合并症而言,85.6%的参与者有糖尿病,42.4%有高血压,22%有血脂异常。在有无合并症的患者中,所有血小板和脂质参数均无差异。虽然所有血小板指数都随着中风严重程度的增加而增加,但我们发现 PDW 是预测中风最可靠的指标,其接受者操作特征曲线下面积为 0.942,截断值为 14 时的敏感性和特异性为 92.1%。所有血小板参数在严重脂质功能障碍患者中也显著增加,确立了脂质谱、血小板指数和中风之间的相关性。

结论

我们发现所有血小板参数与中风之间存在显著关系。因此,我们认为,动脉粥样硬化的危险因素患者应定期评估其血小板指数,以预防脑血管事件的发生。此外,如果适当治疗,血脂异常是中风的可改变危险因素,可以降低发病率和死亡率,从而促进更健康的社会。

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