The association of mean platelet volume levels with hypertensive retinopathy

The pathophysiological mechanism of hypertensive retinopathy (HR) is not fully established. Elevated blood pressure alone does not fully account for the extent of retinopathy so other pathogenic mechanisms may be involved, such as increased platelet activation. Mean platelet volume (MPV) is a marker of platelet activation. Therefore, this study was designed to answer the following questions: Do MPV levels change in HR? and is there any relation between degree of HR and MPV levels? This study included newly diagnosed and 57 untreated essential hypertensive patients with HR. The hypertensive patients were divided into two groups according to the Keith, Wagener classification. Group 1 comprised 29 hypertensive patients with grade 1 HR with a mean age of 56.8 +/- 9.7 years. Group 2 comprised 28 hypertensive patients with grade 2 HR with a mean age of 58.1 +/- 10.3 years. Twenty-seven normotensive subjects who were the healthy participants and had undergone the check-up program were used as the control group. Fundoscopic examination, metabolic parameters and MPV levels were measured in all groups. The level of MPV in group 2 was significantly higher than in group 1 (8.9 +/-0 0.8 fl vs. 8.3 +/- 0.8 fl, p = 0.02) and the normotensive control group (8.9 +/- 0.8 fl vs 7.8 +/- 0.7 fl, p < 0.001). It was also higher in group 1 than in normotensive control group (8.3 +/- 0.8 fl vs.7.8 +/- 0.7 fl, p < 0.01). In addition, MPV showed a positive correlation with the degree of HR in the hypertensive group (r = 0.41, p = 0.015). Our study suggests that platelet activation, a mechanism known to be involved in vascular lesions, may promote the development of HR.     

Increased platelet activation in patients with slow coronary flow

We tested the hypothesis that increased platelet activation may be present in patients with slow coronary flow (SCF) and may contribute to the pathogenesis of slow coronary flow phenomenon (SCFP). Fifty patients angiographically proven normal coronary flow (control group; mean age = 61.3 ± 7.0 years, 43 male) and 50 patients with angiographically proven SCF in all coronary arteries (patient group; man age = 62.7 ± 6.7 years, 38 male) were included in the present study. Coronary flow rates of all subjects were documented by Thrombolysis In Myocardial Infarction frame count (TIMI frame count). Patients with a corrected TIMI frame count greater than two standard deviations from normal published range for the particular vessel were considered as having SCF. Complete blood count and mean platelet volume (MPV) was measured from whole blood sample with Abbott Cell-Dyne 4000 cell counter. Plasma sP-selectin concentrations were analyzed with sP-Selectin ELISA kit. There were no statistically significant differences between the two groups with respect to baseline demographic, clinical and lipid parameters. Not only MPV values but also plasma sP-selectin levels were significantly higher in patients with the patients with SCF compared to those of controls (for MPV; 8.2 ± 0.7 vs. 7.2 ± 0.6 fl, P < 0.001, for sP-Selectin; 1.5 ± 0.3 vs. 1.0 ± 0.2 ng/ml, P < 0.001). Interestingly, significant positive correlations were detected between mean TIMI frame counts and MPV and sP-selectin levels (for MPV; r = 0.56, P < 0.001, for sP-selectin r = 0.67, P < 0.001). The current study demonstrates that platelet activity is increased in the patients with SCF compared to that of the patients with normal coronary flow.     

Platelet activation in patients with Familial Mediterranean Fever

Increased platelet activation and aggregation are central processes in the pathophysiology of atherosclerosis. Increased platelet activity is associated with increased platelet volume. Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk factor for atherothrombosis. Familial Mediterranean Fever (FMF) is an autosomal recessive disease characterized by recurrent inflammatory febrile attacks of serosal and synovial membranes. Recently few studies have shown that FMF is associated with increased atherosclerosis risk. The present study was designed to evaluate levels of MPV in FMF patients compared with healthy subjects. We selected 35 FMF patients and 35 healthy control subjects matched for age, gender, and body mass index. Metabolic parameters and MPV levels were measured in all groups. Metabolic parameters were not different among the study groups (p > 0.05). The levels of MPV were significantly higher in the FMF group than in the control group (8.6 +/- 0.9 fl vs 7.8 +/- 0.5 fl, p = 0.001). The MPV levels were negatively correlated with duration of colchicine treatment (r = -0.40, p = 0.017). Also MPV levels showed positive correlation with delay of diagnosis (r = 0.58, p = 0.001). In conclusion, our results suggest that patients with FMF tend to have an increased platelet activation. Increased platelet activity could contribute to increasing the atherosclerotic risk in FMF patients.     

The effects of continuous positive airway pressure therapy on mean platelet volume in patients with obstructive sleep apnea

Previous studies have reported increased platelet activation and aggregation in patients with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) treatment has been shown to decrease platelet activation. We aimed to study the effects of nasal CPAP therapy has on MPV values in patients with severe OSA. Thirty-one patients (21 men; mean age 53.8?±?9.2 years) with severe OSA (AHI?>?30 events/hour) constituted the study group. An age, gender and body mass index (BMI) matched control group was composed 25 subjects (14 men; mean age 49.6?±?8.5 years) without OSA (AHI?相似文献   

Increased mean platelet volume is associated with arterial stiffness

The brachial-ankle pulse wave velocity (baPWV) is a useful index of arterial stiffness. Mean platelet volume (MPV), an indicator of platelet activation, is associated with hypertension, stroke, and coronary artery disease, all of which may be caused by arteriosclerosis. However, little research has been conducted to investigate the relationship between MPV and arterial stiffness. In this cross-sectional study, we investigated the relationship between platelet count, MPV, and baPWV in 2645 apparently healthy Chinese participants (1676 men, 969 women) in a general health examination. Different metabolic parameters were compared across MPV quintiles (Q1: ≤8.1 fl, Q2: 8.2-8.5 fl, Q3: 8.6-9.6 fl, Q4: 9.7-10.7 fl, and Q5: ≥10.8 fl). Age-adjusted mean values of baPWV gradually increased with MPV quintiles (Q1?=?1124, Q2?=?1134, Q3?=?1199, Q4?=?1207, and Q5?=?1270?cm/s). Univariate analysis showed that age, sex, smoking status, body mass index (BMI), systolic blood pressure (SBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), total platelet count, and MPV were significantly associated with baPWV. In addition, age, sex, BMI, MPV, SBP, and FPG were significant factors in the multivariate model with baPWV. Notably, MPV was found to be a significant determinant for baPWV (β?=?0.198; P?相似文献   

The association of mean platelet volume levels with hypertensive retinopathy

The pathophysiological mechanism of hypertensive retinopathy (HR) is not fully established. Elevated blood pressure alone does not fully account for the extent of retinopathy so other pathogenic mechanisms may be involved, such as increased platelet activation. Mean platelet volume (MPV) is a marker of platelet activation. Therefore, this study was designed to answer the following questions: Do MPV levels change in HR? and is there any relation between degree of HR and MPV levels? This study included newly diagnosed and 57 untreated essential hypertensive patients with HR. The hypertensive patients were divided into two groups according to the Keith, Wagener classification. Group 1 comprised 29 hypertensive patients with grade 1 HR with a mean age of 56.8 ± 9.7 years. Group 2 comprised 28 hypertensive patients with grade 2 HR with a mean age of 58.1 ± 10.3 years. Twenty-seven normotensive subjects who were the healthy participants and had undergone the check-up program were used as the control group. Fundoscopic examination, metabolic parameters and MPV levels were measured in all groups. The level of MPV in group 2 was significantly higher than in group 1 (8.9 ± 0.8 fl vs.8.3 ± 0.8 fl, p = 0.02) and the normotensive control group (8.9 ± 0.8 fl vs 7.8 ± 0.7 fl, p < 0.001). It was also higher in group 1 than in normotensive control group (8.3 ± 0.8 fl vs.7.8 ± 0.7 fl, p < 0.01). In addition, MPV showed a positive correlation with the degree of HR in the hypertensive group (r = 0.41, p = 0.015). Our study suggests that platelet activation, a mechanism known to be involved in vascular lesions, may promote the development of HR.     

接受直接经皮冠状动脉介入治疗的ST段抬高型急性心肌梗死患者血小板体积的变化及与冠状动脉影像的关系

目的 观察接受直接经皮冠状动脉介入( PPCI)治疗的ST段抬高型急性心肌梗死( STEMI)患者血小板体积的变化及与冠状动脉影像和血流的关系.方法 163例接受PPCI治疗的STEMI患者,入院时测定平均血小板体积(MPV)、大血小板比例(P-LCR)等血小板功能参数和血生化指标,阅读冠状动脉影像资料,评估梗死相关动脉( IRA)行PPCI前后的TIMI血流分级,计算IRA行PPCI后校正的TIMI血流帧数计数(CTFC).同期冠状动脉造影等确诊的107例稳定性心绞痛患者作为对照.结果 STEMI患者MPV和P-LCR显著高于稳定性心绞痛组[(10.30 ±0.82)fl比(9.89±0.98)fl,t =3.656,P =0.000; (27.24 ±6.43)％比(24.51±5.88)％,t=3.524,P =0.000]. STEMI患者各亚组间比较,MPV和P-LCR于多支病变亚组显著高于单支病变亚组[(10.40 ±0.85)fl比(10.04±0.69)fl,t=-2.558,P=0.011;(27.96±6.64)％比(25.40±5.52)％,t=-2.319,P=0.022].左前降支亚组显著高于回旋支亚组[( 10.42 ±0.86)fl比(9.98 ±0.62)fl,P＜0.05; (28.07±6.63)％比(24.48±4.76)％,P＜0.05].IRA无自发性开通亚组显著高于自发性开通亚组[(10.39±0.84)fl比( 10.04 ±0.69)fl,t=-2.460,P=0.015;(27.83±6.61)％比(25.64±5.70)％,t=- 2.082,P=0.040].IRA行PPCI后血流未达TIMI3级亚组显著高于达TIMI3级亚组[(10.68±1.02) fl比(10.22 ±0.76)fl,t =2.225,P =0.003; (30.42±7.84)％比(26.61±5.95)％,t=2.393,P=0.023].多元线性回归分析显示,MPV或P-LCR是IRA行PPCI后CTFC的独立影响因素(r=0.294,P=0.001;r =0.243,P=0.004).结论 STEMI患者血小板体积显著增加,血小板体积与冠状动脉病变及IRA行PPCI前后血流的受损程度有密切关系.     

The effect of weight loss on the mean platelet volume in obese patients

Obesity is a chronic metabolic disorder associated with cardiovascular disease and atherosclerosis. Platelet activation and aggregation are central processes in the pathophysiology of cardiovascular disease. Mean platelet volume (MPV), a determinant of platelet activation, is a newly emerging risk marker for atherothrombosis. Our objective was to evaluate the effect of weight loss on the MPV in obese patients. We selected 30 obese women patients and 30 non-obese healthy women subjects. All obese patients took the same content and caloric diet treatment for 3 months. Body mass index (BMI), metabolic parameters and MPV were measured at baseline and after 3 months diet treatment. Before diet treatment, obese group had significantly higher MPV levels than in the non-obese control group (8.18 +/- 1.09 fl vs. 8.01 +/- 0.95 fl, p = 0.004). MPV showed positive correlations with BMI level in the obese group (r = 0.43, p = 0.017). BMI significantly decreased after diet treatment (36.2 +/- 3.2 kg/m(2) vs. 34.7 +/- 3.6 kg/m(2), p < 0.001), in the obese group. MPV significantly decreased after diet treatment in the obese group (8.18 +/- 1.09 fl vs. 8.08 +/- 1.02 fl, p = 0.013). There was a positive correlation between weight loss and reduction in MPV (r = 0.41, p = 0.024). In addition to its well-known positive effects on cardiovascular disease risk, weight loss may also possess significant anti-platelet activation properties that can contribute its antiatherogenic effects in obese patients.     

Platelet activation in subjects with impaired glucose tolerance

Impaired glucose tolerance (IGT), a prediabetic state, is associated with an increased risk of cardiovascular disease. Mean platelet volume (MPV), a determinant of platelet activation, is a newly emerging risk factor for atherothrombosis. This study was designed to answer the following questions: (i) Do MPV levels change in IGT? (ii) Is there any relation between MPV levels and 2 h plasma glucose levels after 75 g oral glucose tolerance test. We selected 48 subjects with IGT, and 48 healthy subjects with normal glucose tolerance matched for age, gender, and body mass index. MPV was significantly higher in IGT group than in control group (9.06 +/- 1.5 fl vs. 8.28 +/- 0.8 fl, p = 0.002). Also, MPV was positively correlated with 2 h plasma glucose concentration in IGT group (r = 0.39, p = 0.006). In conclusion, our results suggest that subjects with IGT tend to have increased platelet activation. Increased platelet activity could contribute to increasing the risk of cardiovascular disease in IGT.     

Increased platelet volume in a general population with prehypertension: a cross-sectional study of 80?545 participants from China

Mean platelet volume (MPV), an indicator of platelet activation, has been shown to be elevated in patients with hypertension. However, data available on the association between MPV level and prehypertension are limited. Prehypertension is also associated with an increase in cardiovascular morbidity and mortality. A cross-sectional study was performed among 80?545 standardized medical checkup participants 18 years in age without hypertension or diabetes in China between April 2009 and May 2010. Blood pressure was categorized as prehypertensive (systolic blood pressure, 120-140?mm?Hg and/or diastolic blood pressure, 80 to 90?mm?Hg, n=36?586) and normotensive (systolic blood pressure, <120?mm?Hg and diastolic blood pressure, <80?mm?Hg, n=43?959). Mean systolic blood pressure and the prevalence of prehypertension increased significantly with increasing MPV. After adjusting for demographics, body mass index, smoking and serum cholesterol, the odds ratio for prehypertension, when comparing the highest category of MPV (>12.0?fl) with the lowest category (<10.1?fl), was 1.08 (95% confidence interval, 1.02-1.13; P for trend=0.014). This association persisted in separate analysis among men but not among women. In nonparametric models, the positive association between MPV and prehypertension appeared to be present across the full range of MPV, without any threshold effect. Increased MPV is associated with prehypertension in a large sample of Chinese adults that are free of cardiovascular disease and hypertension.     

非糖尿病、非肥胖、非ST段抬高急性冠状动脉综合征患者平均血小板体积与胰岛素抵抗的相关性分析

目的:观察无糖尿病、不肥胖的非ST段抬高急性冠状动脉综合征患者,平均血小板体积(mean platelet volume,MPV)与胰岛素抵抗的相关性和临床的意义。方法:连续入选236例非糖尿病、非肥胖、非ST段抬高急性冠状动脉综合征患者,测定外周血液学指标以及其他生化指标。根据稳态模型胰岛素抵抗指数(homeostasis model assessment insulin resistance index,HOMA-IR)分为胰岛素抵抗组90例和胰岛素敏感组146例。比较两组患者临床和血液学参数。结果:胰岛素抵抗患者男性(P=0.003)、高血压(P=0.004)、超质量(P0.001)比例高;服用β-受体阻滞剂(P=0.003)和硝酸脂类药物(P=0.001)比例高。胰岛素抵抗组患者TG、UA、高敏C-反应蛋白、空腹血糖、空腹胰岛素、C-肽、HOMA-IR、BMI、MPV、血小板分布宽度、大血小板比例、红细胞计数和血红蛋白含量,也较胰岛素敏感组患者明显增高(P0.05),HDL-C明显降低(P=0.03)。相关分析显示,MPV分别与HOMA-IR(r=0.35,P0.001)、空腹胰岛素(r=0.37,P0.001)、C-肽(r=0.27,P0.001)、血小板分布宽度(r=0.53,P0.001)、大血小板比例(r=0.74,P0.001)以及BMI(r=0.17,P=0.009)呈正相关,与血小板计数呈负相关(r=-0.46,P0.001)。结论:对于非糖尿病、非肥胖、非ST段抬高急性冠状动脉综合征患者,MPV在胰岛素抵抗组明显增加且与HOMA-IR呈显著正相关,胰岛素抵抗的非ST段抬高急性冠状动脉综合征患者血小板激活程度较高,应该采取更积极的抗血小板策略。     

Platelet activation in patients with Familial Mediterranean Fever

Increased platelet activation and aggregation are central processes in the pathophysiology of atherosclerosis. Increased platelet activity is associated with increased platelet volume. Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk factor for atherothrombosis. Familial Mediterranean Fever (FMF) is an autosomal recessive disease characterized by recurrent inflammatory febrile attacks of serosal and synovial membranes. Recently few studies have shown that FMF is associated with increased atherosclerosis risk. The present study was designed to evaluate levels of MPV in FMF patients compared with healthy subjects. We selected 35 FMF patients and 35 healthy control subjects matched for age, gender, and body mass index. Metabolic parameters and MPV levels were measured in all groups. Metabolic parameters were not different among the study groups (p > 0.05). The levels of MPV were significantly higher in the FMF group than in the control group (8.6 ± 0.9 fl vs 7.8 ± 0.5 fl, p = 0.001). The MPV levels were negatively correlated with duration of colchicine treatment (r = ?0.40, p = 0.017). Also MPV levels showed positive correlation with delay of diagnosis (r = 0.58, p = 0.001). In conclusion, our results suggest that patients with FMF tend to have an increased platelet activation. Increased platelet activity could contribute to increasing the atherosclerotic risk in FMF patients.     

Platelet surface CD62P and CD63, mean platelet volume, and soluble/platelet P-selectin as indexes of platelet function in atrial fibrillation: a comparison of "healthy control subjects" and "disease control subjects" in sinus rhythm.

OBJECTIVES: The aim of this work was to comprehensively study the role of platelets in atrial fibrillation (AF), in relation to the underlying cardiovascular diseases and type of AF, and to analyze the effect of antithrombotic treatment on different aspects of platelet activation. BACKGROUND: Platelet activation is present in nonvalvular AF, but there is debate whether this is due to AF itself and/or to underlying cardiovascular diseases. METHODS: A total of 121 AF patients were compared with 65 "healthy control subjects" and 78 "disease control subjects" in sinus rhythm. Platelet activation was assessed using 4 different aspects of platelet pathophysiology: 1) platelet surface expression of CD62P (P-selectin) and CD63 (a lysosomal glycoprotein) (by flow cytometry); 2) mean platelet volume (MPV) (by flow cytometry); 3) plasma levels of soluble P-selectin (sP-selectin, enzyme-linked immunoadsorbent assay); and 4) total amount of P-selectin per platelet (pP-selectin) ("platelet lysis" assay). RESULTS: Both AF patients and "disease control subjects" had higher levels of CD62P (p < 0.001), CD63 (p < 0.001), and sP-selectin (p < 0.001) compared with "healthy control subjects," with no difference between AF patients and "disease control subjects." Patients with permanent AF had higher levels of sP-selectin (p = 0.014) and MPV (p = 0.025) compared with those with paroxysmal AF. The presence of AF independently affected the levels of CD62P expression, while "high-risk" AF patients (CHADS score > or =2) had higher levels of CD62P compared with those with "low risk." Introducing warfarin resulted in a reduction of pP-selectin (p = 0.013). CONCLUSIONS: There is a degree of excess of platelet activation in AF compared with "healthy control subjects," but no significant difference between AF patients and "disease control subjects" in sinus rhythm. Platelet activation may differ according to the subtype of AF, but this is not in excess of the underlying comorbidities that lead to AF. Platelet activation in AF may be due to underlying cardiovascular diseases, rather than due to AF per se.     

急性心肌梗死患者心室血栓与血小板体积和数量的相关性

目的分析急性心肌梗死(AMI)患者并发左心室血栓与平均血小板体积(MPV)和血小板计数(PLT)的相关性。方法回顾性分析2007年1月至2011年4月在阜外心血管病医院住院治疗的69例AMI并心室血栓形成患者,及138例与之年龄匹配(1∶2)的无心室血栓形成的AMI患者。比较两组患者入院时和入院后第6～8天两个时间点的MPV和PLT变化特点,以及分析MPV和PLT的相关性。结果两组患者入院时MPV差异无统计学意义[(10.3±1.0)fl比(10.3±0.8)fl,P=0.854],入院后第6～8天心室血栓组患者的MPV明显高于无心室血栓组[(11.1±1.7)fl比(10.7±0.7)fl,P=0.029]。入院时和入院后第6～8天PLT在两组间差异均无统计学意义(P=0.587、0.807)。入院后第6～8天患者MPV与PLT的关联表现为线性关系。结论 AMI患者MPV增大可能与心室血栓形成相关。     

Platelet activation in subjects with impaired glucose tolerance

Impaired glucose tolerance (IGT), a prediabetic state, is associated with an increased risk of cardiovascular disease. Mean platelet volume (MPV), a determinant of platelet activation, is a newly emerging risk factor for atherothrombosis. This study was designed to answer the following questions: (i) Do MPV levels change in IGT? (ii) Is there any relation between MPV levels and 2 h plasma glucose levels after 75 g oral glucose tolerance test. We selected 48 subjects with IGT, and 48 healthy subjects with normal glucose tolerance matched for age, gender, and body mass index. MPV was significantly higher in IGT group than in control group (9.06 ± 1.5 fl vs. 8.28 ± 0.8 fl, p = 0.002). Also, MPV was positively correlated with 2 h plasma glucose concentration in IGT group (r = 0.39, p = 0.006). In conclusion, our results suggest that subjects with IGT tend to have increased platelet activation. Increased platelet activity could contribute to increasing the risk of cardiovascular disease in IGT.     

The effect of rosuvastatin treatment on the mean platelet volume in patients with uncontrolled primary dyslipidemia with hypolipidemic diet treatment

Platelet activation and aggregation are central processes in the pathophysiology of coronary heart disease. Mean platelet volume (MPV), a determinant of platelet activation, is a newly emerging risk marker for atherothrombosis. Rosuvastatin, a new hydrophilic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin), is approved as an adjunct to diet in patients with dyslipidemia. In this study, we evaluated the effects of rosuvastatin on the MPV levels in patients with uncontrolled primary dyslipidemia with hypolipidemic treatment. We selected 30 age, sex and body mass index matched patients with uncontrolled primary dyslipidemia and hypolipidemic diet treatment and 30 normolipidemic healthy subjects. Dyslipidemic patients were treated with 10 mg/day rosuvastatin for 12 weeks. Metabolic parameters and MPV were measured at baseline and after rosuvastatin treatment in dyslipidemic group. At baseline, the dyslipidemic group had significantly higher MPV levels than in the healthy control group (8.4 +/-1.2 fl vs. 8.1 +/-0 1.0 fl, p < 0.005). The level of MPV decreased significantly after rosuvastatin treatment from a mean of 8.4 +/- 1.2 fl to 8.1 +/- 1.3 fl, (p < 0.001). The changes in MPV levels with rosuvastatin treatment were not correlated to changes in plasma lipids (p > 0.05). In addition to its well-known hypolipidemic effect, rosuvastatin also possesses significant anti-platelet activation properties. This antiplatelet effect of rosuvastatin treatment could play a role in reducing cardiovascular complications in primary hyperlipidemic patients.     

Lifestyle modification decreases the mean platelet volume in prehypertensive patients

Mean platelet volume (MPV) is an indicator of platelet activation. The present study was designed to investigate platelet function by measuring MPV, platelet count (PLC) and platelet mass (PLM) in prehypertensive (PHT) subjects. Additionally, we also evaluated the effects of lifestyle modification on platelet functions by measuring MPV, PLC and PLM. We selected 36 newly diagnosed PHT patients and 21 control subjects (BP < 120/80 mmHg) matched for age and sex. Lifestyle modifications (weight loss, reduced sodium intake, increased physical activity, limited alcohol consumption and the Dietary Approaches to Stop Hypertension (DASH) diet) were recommended to PHT individuals for 20 weeks. At entry into the study, although PLM and PLC values were similar between study groups, MPV values were significantly higher in the PHT group than in the control group (respectively, 10.41 ± 0.93 fl vs. 9.56 ± 1.04 fl, p < 0.01). Additionally, MPV was positively correlated with the systolic blood pressure (BP), body mass index (BMI) and insulin resistance (IR) in the PHT group (r: 0.41; p < 0.02, r: 0.37; p < 0.04, r: 0.35; p < 0.05, respectively). Only age and PHT were found to be independent predictors of MPV after regression analysis. The program substantially lowered BP (net reductions in systolic and diastolic BPs of 16.2 and 8.7 mmHg, p < 0.001, p < 0.001, respectively). In addition, BMI, waist circumference (WC) and IR were significantly reduced in the PHT group (p < 0.01, p < 0.01, p < 0.05, respectively). At the end of study, although PLM, PLC values were reduced in the PHT group, only the decrease in MPV reached statistical significance (respectively, 10.41 ± 0.93 fl vs. 9.67 ± 1.2 fl, p < 0.01). In closing, to our best notice, our study is the first to display a significant increase in MPV in PHT subjects and to show a decrease in MPV by lifestyle modification after 20 weeks. As a result, we consider that decreased platelet activation with multi-aspect effects of lifestyle modification therapy might play an important role in reducing thrombotic risk in PHT patients.     

急性冠状动脉综合征患者平均血小板体积的变化及相关因素研究

目的观察急性冠状动脉综合征(ACS)患者平均血小板体积(MPV)的变化及其相关因素。方法选取接受冠状动脉造影的ACS患者195例,慢性稳定型心绞痛(SA)患者48例和非冠心病对照73例。ACS包括非ST段抬高型ACS(NSTEACS)114例和ST段抬高型心肌梗死(STEMI)81例,又分为合并糖尿病患者66例和未合并糖尿病患者129例。测定MPV、血小板压积(PCT)等。结果与对照组[(9.59±1.40)fl]和SA组[(9.61±1.42)fl]比较,ACS组[(10.19±1.26)fl]、NSTEACS亚组[(10.12±1.35)fl]和STEMI亚组[(10.29±1.33)fl]的MPV均显著升高(均为P<0.01);与对照组(45.2%±49.9%)和SA组(49.6%±55.4%)比较,ACS组(33.1%±35.4%)及STEMI亚组(29.9%±29.8%)的PCT均显著降低(均为P<0.05);合并糖尿病亚组MPV显著高于未合并糖尿病亚组[(10.48±1.29)fl比(10.05±1.23)fl,P<0.05];多元回归分析显示,血清高敏C反应蛋白(hsCRP)和HDL-C是MPV的独立影响因素(r=0.209,-0.191,均为P<0.01)。结论ACS患者MPV显著升高,糖尿病、血清hsCRP水平和HDL-C与MPV的升高有密切关系。     

Can mean platelet volume predict coronary vasospasm?

Mean platelet volume (MPV) is an index of platelet function that reflects platelet production rate and sensitivity to activation. The relationship between MPV and coronary vasospasm has not been previously studied. In this study, we aimed to evaluate this relationship. A total of 696 patients (age 55.20?±?12.26, male 46.4%, female 53.6%) with typical or atypical angina who underwent diagnostic coronary angiography (CAG) and an acetylcholine (Ach)-provocation test were enrolled. Each patient was assigned to either an Ach-induced coronary vasospasm group (n?=?183) or a control group (n?=?513). We compared MPV between the two groups. MPV and the platelet count showed a negative correlation (r?=?-0.289, p?相似文献   

Angiotensin II can induce and potentiate shape change in human platelets: effect of losartan

Platelet shape change (PSC) is an early phase of platelet activation that precedes platelet aggregation. This phase of platelet activation is essentially aspirin resistant. PSC was monitored, by measuring the median platelet volume (MPV) using a high resolution channelyser. Angiotensin (Ang) II, added in vitro, caused a significant (P = 0.004) increase in MPV in platelet rich plasma prepared from healthy subjects (n = 14). This increase in MPV was marked (>0.40 fl) in 57% (n = 8) of these subjects and was significantly inhibited (P<0.008) by losartan (a selective Ang II antagonist) at concentrations similar to those achieved in the circulation during treatment. Ang II also significantly enhanced sub-maximal PSC induced by ADP and serotonin in all subjects tested. Losartan significantly (n = 9; P<0.001) inhibited U46619 (a thromboxane A2 analogue)-induced PSC. These findings suggest that losartan, in addition to its blood pressure lowering action, has antiplatelet activity. This property may be clinically relevant because of the increased risk of vascular events in hypertensive patients.