急性脑梗死患者外周血平均血小板体积与颈动脉粥样硬化的相关性研究

目的 探讨急性脑梗死患者外周血平均血小板体积（mean platelet volume，MPV）水平与颈动脉粥样硬化的相关性。方法 纳入99例发病1周内的急性脑梗死患者为观察组，30例同期无心脑血管疾病，并经多普勒彩色超声检查无颈动脉内膜增厚的健康体检者为对照组。检测所有纳入者的外周血MPV水平，采用多普勒彩色超声检查颈动脉内膜中层厚度（intima media thickness，IMT），按病变程度将观察组分为IMT正常组、IMT轻度狭窄组、IMT中重度狭窄组；根据头颅CT或MRI提示的梗死面积大小将观察组分为小面积、中等面积、大面积脑梗死组。分析比较观察组与对照组以及观察组各亚组间MPV水平的差异，并分析MPV与IMT及梗死面积的相关性。结果 脑梗死组外周血MPV水平较对照组升高，差异有统计学意义（P<0.05）；观察组不同颈动脉狭窄程度组外周血MPV比较差异有统计学意义（P=0.000）；Pearson相关性分析表明，MPV与IMT值呈正相关（r=0.331，P=0.000），MPV与脑梗死面积呈正相关（r=0.386，P=0.000）；ROC曲线显示MPV对急性脑梗死的预测曲线下面积为0.682，最佳界值是11.45，敏感度为41.4%，特异性为86.7%。结论 急性脑梗死患者外周血MPV水平与颈动脉粥样硬化狭窄程度密切相关，且对急性脑梗死有一定的预测价值。

Relationship between Levels of Mean platelet volume and Carotid Intima-Media Thick-ness in Acute Cerebral Infarction Patients

Objective To investigate the relationship between levels of mean platelet volume (MPV)and carotid atherosclerosis in patients with acute cerebral infarction. Methods A total of 99 patients were chosen for the observation group. Another 30 healthy people were for control group. The level of mean platelet volume in all subjects was detected bby enzymatic cycling assay and the carotid intimamedia thickness(IMT) of all patients was checked using color Doppler echocardiography. According to IMT degree,the patients in observation group were divided into IMT nomal group,IMT mild stenosis group and IMT moderate,severe stenosis group. According to the size of area of skull CT or MRI brain infarction, groups can be divided into a small area of cerebral infarction group, middle area of cerebral infarction group, the large area cerebral infarction group. The level of mean platelet volume between observation group and control group as well each subgroup of observation group was compared,and its correlation with IMT was also analyzed. Results The level of mean platelet volume in observation group was higher than in healthy control group(P<0.05).Cerebral infarction patients with different degree of carotid stenosis group of peripheral blood MPV comparative difference was statistically significant(P=0.000).Pearson correlation analysis displayed that the level of mean platelet volume was positively correlated with IMT(r=0.331,P=0.000),and positively correlated with Cerebral infarction volume.The optimal cut-off value of MPV was 11.45,with a sensitivity of 41.4% and a specificity of 86.7% for predicting ischemic stroke. Conclusion Increased MPV is closely associated with carotid artery stenosis and its degree in cerebral infarction patients.