Tian Shi-Yuan, Yu Min-Jie, Mei Kefu, Xu Bing, Xiao Lian-Chen, Wen Hong-Bin, Shang Fu-Rong
Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People's Republic of China.
School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Ther Clin Risk Manag. 2025 May 19;21:715-725. doi: 10.2147/TCRM.S522253. eCollection 2025.
The aim of this study is to investigate the relationship between admission platelet indices and 90-day clinical outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT).
A retrospective analysis was conducted on 247 AIS patients with anterior circulation large vessel occlusion (LVO) treated with MT between July 2021 and April 2024. Platelet indices (PIs) were measured at admission. Participants were stratified into two groups based on 90-day modified Rankin Scale (mRS) outcomes. Multivariate regression analysis and receiver operating characteristic (ROC) curves were employed to evaluate relationships between admission platelet indices, clinical parameters, and functional outcomes.
Among 247 enrolled patients, those with unfavorable outcomes (mRS 3-6) exhibited significantly higher platelet distribution width (PDW) and Mean Platelet Volume (MPV) levels compared to the favorable outcome group (mRS 0-2). Elevated MPV remained an independent predictor of unfavorable outcomes after multivariate adjustment (OR=2.747, 95% CI: 1.791-4.216, <0.001). ROC analysis identified a MPV threshold >10.75 fL for predicting unfavorable prognosis, demonstrating 55.4% sensitivity and 81.2% specificity.
PDW is associated with unfavorable 90-day outcomes in patients with acute anterior circulation LVO following MT, while elevated MPV may serve as a prognostic indicator for unfavorable functional outcomes in patients with acute anterior circulation LVO following MT.
本研究旨在探讨接受机械取栓术（MT）的急性缺血性卒中（AIS）患者入院时血小板指标与90天临床结局之间的关系。
对2021年7月至2024年4月期间接受MT治疗的247例前循环大血管闭塞（LVO）的AIS患者进行回顾性分析。入院时测量血小板指标（PIs）。根据90天改良Rankin量表（mRS）结局将参与者分为两组。采用多变量回归分析和受试者工作特征（ROC）曲线来评估入院时血小板指标、临床参数和功能结局之间的关系。
在247例入组患者中，与预后良好组（mRS 0-2）相比，预后不良（mRS 3-6）的患者血小板分布宽度（PDW）和平均血小板体积（MPV）水平显著更高。多变量调整后，MPV升高仍然是不良结局的独立预测因素（OR=2.747，95%CI：1.791-4.216，<0.001）。ROC分析确定MPV阈值>10.75 fL可预测不良预后，敏感性为55.4%，特异性为81.2%。
PDW与MT术后急性前循环LVO患者90天不良结局相关，而MPV升高可能是MT术后急性前循环LVO患者不良功能结局的预后指标。
