急性冠脉综合征血小板平均体积的相关性研究

目的观察急性冠脉综合征（acutecoronarysyndrome,ACS）患者平均血小板体积（meanplateletvolume,MPV）的变化及其影响因素。方法测定230例接受冠状动脉造影的ACS患者,55例慢性稳定型心绞痛（SA）患者和91例非冠状动脉粥样硬化性心脏病对照患者的MPV、血小板压积等实验室检查指标并行超声心动图检查,对所得数据进行统计学分析。ACS患者包括非sT段抬高性ACS（nonSTelevatedACS,NSTEACS）亚组135例和急性sT段抬高性心肌梗死（acutemyocardialinfarction。AMI）亚组95例。结果ACS组[（10．26±1．19）fL135．（9．79±1．37）fL,P〈0．05;（10．26±1．19）fLvs（9．72±1．40）fL,P〈0．05]及NSTEACS亚组J（10．19±1．24）fLvs．（9．79±1．37）fL,P〈0．05;（10．19±1．24）fL％（9．72±1．40）fL,P〈0．05]和AMI亚组[（10．35±1．11）fL％（9．79±1．37）fL,P〈0．05;（10．35±1．11）fLUS．（9．72±1．40）fL,P〈0．05]的MPV显著高于对照组和sA组,差异有统计学意义。ACS组10．21（0．08）％VS．0．23（0．08）％,P〈0．05;0．21（0．08）％vs．0．24（0．10）％,P〈0．05]、NSTEACS亚组[0．21（0．09）％vs．0．23（0．08）％,P〈0．05;0．21（0．09）％vs．0．24（0．10）％,P〈0．05]及AMI亚组[0．21（0．08）％vs．0．23（0．08）％,P〈0．05;0．21（0．08）％眠0．24（0．10）％,P〈0．05]的血小板压积显著低于对照组和sA组,差异有统计学意义。ACS患者MPV与高密度脂蛋白胆固醇呈负相关（r=-0．175,P=0．008）,与高敏c反应蛋白呈正相关（r=0．181,P=0．008）,与左心室射血分数负相关（r=-0．157,P=0．017）。多元线性回归分析显示,MPV的预测因素依次是糖尿病、高敏C反应蛋白、左心室射血分数和高密度脂蛋白胆固醇（均P〈0．01）。结论ACS患者MPV显著升高,糖尿病、高敏C反应蛋白、左心室射血分数和高密度脂蛋白胆固醇与MPV的升高有密切关系。     

Proceedings of an international symposium forum on platelet transfusion. Evolving Alternative Therapeutic Products 10 April 1997, Edinburgh,Scotland

Abstract

The aim of this study was to determine the associations of the mean platelet volume (MPV) high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT-proBNP) with the development of adverse outcomes after percutaneous coronary intervention (PCI). MPV hs-cTnT and NT-proBNP were analyzed in 372 patients who underwent PCI. The primary endpoint was cardiac death. The secondary endpoint analyzed was cardiovascular events (CVE): the composite of cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), ischemic stroke and stent thrombosis (ST). The median MPV hs-cTnT and NT-proBNP levels were 8.20 (IQR 7.70–8.70) fL, 0.291 (IQR 0.015–3.785) ng/mL, and 105.25 (IQR 50.84–1128.5) pg/mL, respectively. There were 21 events of cardiac death, 10 MI (including 4 events of ST), 7 ischemic strokes and 29 TVR during a mean of 25.8 months of follow-up. The Kaplan–Meier analysis revealed that the higher MPV group (>8.20?fL, median) had a significantly higher cardiac death rate than the lower MPV group (≤8.20?fL; 9.4% vs. 2.1%, log-rank: p?=?0.0026). When the MPV cut-off level was set to 8.20?fL using the receiver operating characteristic curve, the sensitivity was 81% and the specificity was 53.3% for differentiating between the group with cardiac death and the group without cardiac death. This value was more useful in patients with myocardial injury (hs-cTnT?≥?0.1?ng/mL) or heart failure (NT-proBNP?≥?450?pg/mL). The results of this study show that MPV is a predictive marker for cardiac death after PCI; its predictive power for cardiac death is more useful in patients with myocardial injury or heart failure.     

Logistic回归联合受试者工作特征曲线评价血小板参数对急性冠脉综合征的诊断价值

目的：探讨平均血小板体积（MPV）和大型血小板比例（P-LCR）在胸痛患者急性冠脉综合征（ACS）中的诊断价值。方法测定83例2013年1月至6月因胸痛就诊于空军总医院的ACS患者和56例非心源性胸痛患者的血小板参数,通过组间均值比较和logistic回归分析筛选出有效指标,并利用受试者工作特征（ROC）曲线评价其在ACS判断中的诊断价值。结果（1）与非心源性胸痛患者相比,ACS患者血小板数量减少[（191.28±67.07）x10^9/L vs（236.75±64.09）x10^9/L], MPV[（11.88±1.24） vs （10.73±1.08）fL]、血小板分布宽度（PDW）[（15.54±1.87） vs（13.40±2.35）fL]和P-LCR[（47.49±9.55）% vs （35.11±10.00）%]等明显升高（P＜0.05）;（2）不同临床类型的ACS患者血小板参数无显著变化（P＞0.05）;（3）logistic分析表明P-LCR和MPV是ACS的辅助诊断指标;（4）ROC曲线显示肌钙蛋白Ⅰ、P-LCR、MPV、肌酸激酶同工酶对应的诊断界值分别是0.15μg/L、38.5%、11.05fL和19.0U/L,曲线下面积分别为0.987,0.817,0.754和0.598,灵敏度为97.3%,92.8%,71.1%和45.8%,特异度为90.3%,64.3%,62.5%和73.2%,诊断符合率100%,80%,72.6%和67.2%。结论 MPV和P-LCR分别有助于ACS的发现,可作为胸痛患者ACS的辅助诊断指标,由于MPV和P-LCR升高对ACS的判断准确性较高,因此可以为ACS的早期判断和鉴别诊断提供参考。     

Brachial-ankle pulse wave velocity and mean platelet volume as predictive values after percutaneous coronary intervention for long-term clinical outcomes in Korea: A comparable and additive study

This study aimed to determine the association of the brachial-ankle pulse wave velocity (baPWV) and mean platelet volume (MPV) with the development of adverse outcomes after percutaneous coronary intervention (PCI). The baPWV and MPV were analyzed in 372 patients who underwent PCI, with the primary endpoint as cardiac death. The secondary endpoint was cardiovascular events (CVE): a composite of cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), ischemic stroke, and stent thrombosis (ST). During the follow-up period (mean, 25.8 months), there were 21 cardiac deaths, 10 MIs including four events of ST, seven ischemic strokes, and 29 TVRs. The baPWV cut-off level was set at 1672?cm/s using the receiver operating characteristic curve; the sensitivity and specificity was 85.7 and 60.1%, respectively, to differentiate between the groups with and without cardiac death. The MPV cut-off level was set at 8.20?fL using the receiver operating characteristic curve; the sensitivity and specificity were 81 and 53.3%, respectively, to differentiate between the groups with and without cardiac death. Kaplan–Meier analysis revealed that the higher baPWV group (≥1672?cm/s) had a significantly higher cardiac death and CVE rate than the lower baPWV group (<1672?cm/s) (11.4 vs. 1.4%, log-rank: p?<?0.0001; 25.3 vs. 7.5%, log-rank: p?<?0.0001; respectively), and the higher MPV group (median, >8.20?fL,) had a significantly higher cardiac death and CVE rate than the lower MPV group (≤8.20?fL) (9.4 vs. 2.1%, log-rank: p?=?0.0026; 23.8 vs. 6.8%, log-rank: p?<?0.0001; respectively). Furthermore, the high baPWV and MPV groups were significantly associated with an increased risk of cardiac death. These results show that baPWV and MPV are predictive markers after PCI for cardiac death; they are also additively associated with a higher risk of cardiac death.     

Mean platelet volume as a predictor for long-term outcome after percutaneous coronary intervention

Mean platelet volume (MPV) is a value that is available from standard blood count. Increased MPV is associated with increased platelet reactivity and it has been correlated with adverse cardiac outcomes in patients with acute coronary syndromes (ACS). However, there is limited information about the prognostic value of baseline MPV in a large heterogenous patient population which undergoes percutaneous coronary intervention (PCI). To examine whether baseline MPV is predictive of clinical outcomes in patients who undergo PCI. Included were consecutive patients who underwent PCI during 2004–2010 (n = 7,585, mean age 67.7 ± 12.1 years, 76.0 % males) with a median follow-up period of 4 years. Baseline MPV before angiography and long-term clinical outcomes were assessed. The mean MPV was higher in women as compared to men (8.6 ± 1.2 vs. 8.5 ± 1.1 fL, p = 0.02), in diabetic versus non-diabetic patients (8.6 ± 1.2 vs. 8.4 ± 1.1 fL, p < 0.001) and in patients who were admitted with ACS (n = 4,961) compared to patients who underwent an elective PCI (8.6 ± 1.1 vs. 8.5 ± 1.1 fL, p = 0.001). On multivariate analysis, MPV was associated with mortality (HR 1.18, 95 % CI 1.12–1.23, p < 0.001) and with a composite end-point of death, MI and target vessel revascularization (HR 1.09, 95 % CI 1.04–1.13, p < 0.001). Baseline MPV was associated with mortality in patients undergoing an elective PCI as well as in urgent PCI (HR 1.30, 95 % CI 1.20–1.40, p < 0.001 and HR 1.13, 95 % CI 1.07–1.20, p < 0.001, respectively). In patients undergoing either an elective or urgent PCI, an elevated MPV is a significant predictor of cardiovascular adverse events including death.     

Relation between indices of end-organ damage and mean platelet volume in hypertensive patients

Mean platelet volume (MPV) has been recognized as an independent risk factor of hypertension. Hypertensive end-organ damage worsens the prognosis in hypertensive patients. We aimed to investigate the relationship between MPV levels and subclinical end-organ damage in hypertensive patients. One hundred and sixteen hypertensive patients (81 women, 35 men, with a mean age of 53 ± 11) were included in the study. There was no correlation between MPV and left-ventricular mass index (LVMI) (r = 0.145; P = 0.14) or albuminuria (r = 0.009; P = 0.93). Among the individuals that had grade I and grade II retinopathy, MPV levels (8.3 ± 2 fL, 8.2 ± 1.3 fL; P = 0.28) were similar either. We concluded that there was no correlation between MPV and markers of end-organ damage in hypertensive patients.     

An overlooked indicator of disease activity in ulcerative colitis: Mean platelet volume

Many non-invasive tests have been studied for diagnosis and determining the activation degree of inflammatory bowel disease (IBD). Nevertheless, an ideal test has not been found yet. Mean platelet volume (MPV) is influenced by the inflammation. In a few study, decreased platelet volume have been reported in IBD. The aim of this study is to determine whether platelet volume would be useful in ulcerative colitis (UC) activity. Additionally we have analyzed overall accuracy of MPV in disease activity and compared with other inflammatory markers. A total of 61 UC patients (male/female : 41/20), and 27 healthy subjects (male/female : 18/9) were enrolled into the study. For all subjects following tests were performed; ESR, CRP, white blood cell count and mean platelet volume. A statistically significant decrease in MPV was noted in patients with UC (8.29 ± 1.02fL) compared with healthy controls (8.65 ± 0.79 fL). MPV of active UC (8.06 ± 1.19 fL) patients were significantly lower than that of inactive UC (8.45 ± 0.87 fL). Overall accuracy of MPV in determination of active UC was 71% (with sensitivity 67%, specificity 73%). A negative correlation was found between MPV and endoscopic activity index (r : -0.358 p : 0.005). In UC, MPV did not correlate with ESR, CRP and white blood cell. Our study showed that MPV reduced in UC, particularly in patients with active UC. Decreased MPV may be an indicator for increased disease activity in patients with UC.     

Mean platelet volume and D-dimer in patients with suspected deep venous thrombosis

The aim of this retrospective study was to evaluate the diagnostic value of mean platelet volume (MPV) and D-dimer for acute deep venous thromboembolism (DVT). Two hundred and fifty six patients who presented to the emergency or cardiovascular surgery department with suspected lower limb DVT were retrospectively recruited. Plasma levels of MPV, platelet count, and D-dimer were obtained and duplex sonography examination was performed for all patients. Eighty four patients had acute DVT which was diagnosed by duplex ultrasonography. MPV was significantly higher in patients with DVT than in those without DVT (p < 0.01). The mean MPV was 7.97 ± 17.8 and 7.58 ± 0.87 fL in patients with DVT and without DVT, respectively (p < 0.01). D-dimer was significantly higher in patients with DVT (p < 0.01). For all the patients, a positive MPV when the cut-off value was 7.3 fL, had 69.7 % sensitivity and 43.9 % specificity. D-dimer (with a cut-off value of 0.5 μg/mL) had 82.9 % sensitivity and 32.7 % specificity. In case of combination of MPV and D-dimer, the specificity exceeded (65.9 %) despite the reduction in sensitivity (59.2 %). Elevated MPV was found to be associated with acute DVT and high levels of MPV might increase the specificity of D-dimer for exclusion of DVT.     

Prognostic value of mean platelet volume in patients with non-ST-elevation acute coronary syndrome

The aim of this study is to determine mean platelet volume (MPV) in a population with non-ST-elevation acute coronary syndrome (nSTEACS) and explore its relation with prognosis. Patients (n = 329) with a diagnosis of nSTEACS at admission were recruited, with a determination of MPV in the first 12 hours at admission. We also collected blood from 87 healthy controls. A composite end point of cardiovascular death and new ACS was assessed at 6-month follow-up. Patients with nSTEACS showed larger platelets (MPV: 11.0 [10.3-11.8] vs 9.2 [8.6-10.0] fL; P < .001.). In Cox regression analysis, MPV at admission was a significant predictor of cardiovascular adverse events in univariate analysis, hazard ratio (HR) 1.4 95% confidence interval (CI) 1.1-1.8; P = .018; but after adjustment with clinical variables, MPV lost its statistical significance. In conclusion, patients with nSTEACS present with larger platelets than healthy controls, however this parameter did not show an independent prognostic significance at 6-month follow-up.     

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 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   

Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome

Objective

Acute coronary syndrome (ACS) is a challenging issue in cardiovascular medicine. Given platelet role in atherothrombosis, we sought to determine whether platelet indices can be used as diagnostic tests for patients who suffered from an acute chest discomfort.

Methods

We prospectively enrolled 862 patients with an acute chest pain and 184 healthy matched controls. They were divided into four groups: 184 controls, 249 of non-ACS, 421 of unstable angina (UA), and 192 of myocardial infarction (MI) cases. Blood samples were collected at admission to the emergency department for routine hematologic tests.

Results

The mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly greater in patients with MI compared with those of non-ACS or control subjects. Negative and significant correlations existed between MPV, PDW, and P-LCR values and platelet count (P < 0.001). Receiver operating characteristic (ROC) curves showed that the MPV, PDW, and P-LCR with cut-off values of 9.15 fL, 11.35 fL, and 20.25% and with area under the curves of 0.563, 0.557, and 0.560, respectively, detected MI patients among those who had chest discomfort. The sensitivities and specificities were found to be 72% and 40%, 73% and 37%, and 68% and 44% for MPV, PDW, and P-LCR, respectively.

Conclusion

An elevated admission MPV, PDW, and P-LCR may be of benefit to detect chest pain resulting in MI from that of non-cardiac one, and also for risk stratification of patients who suffered from an acute chest discomfort.     

Effect of enhanced external counterpulsation treatment on mean platelet volume in patients affected by ischemic chronic heart failure

Mean platelet volume (MPV) is increased in chronic heart failure (CHF) and is an independent predictor of mortality in CHF patients. It is not known whether enhanced external counterpulsation (EECP) therapy leads to decreased MPV values or not. The purpose of this study was to examine the effects of EECP on platelet count and MPV values and to assess the influence of MPV on the risk of death and recurrent ischemic events in ischemic CHF patients. A total of 68 ischemic heart failure patients with CHF symptoms and refractory angina pectoris were included in the study, 47 consecutive patients (39 males and eight females) aged 44-82 years. Although follow-up period started after completion of EECP in treated patients, control group follow-up started at the end of 7-week treatment without EECP. All patients were monitored for a mean duration of 13?±?8 months (range, 1-36 months). The primary endpoints of the study were effects of EECP treatment on platelets after treatment period (7 weeks) and the recurrence of ischemic events. Secondary endpoint was cardiovascular death during the follow-up period. We observed a significant increase in platelet count and decrease in MPV levels (P?=?0.044 and P?=?0.004, respectively) in the control group. There were no significant differences in platelet count and MPV levels in the EECP group (P?>?0.05). After the treatment period, New York Heart Association functional classification (2.60?±?0.75 vs. 1.72?±?0.68, P?相似文献   

Stroke prediction using mean platelet volume in patients with atrial fibrillation

Platelet size, measured as mean platelet volume (MPV), is associated with platelet reactivity. MPV has been identified as an independent risk factor for future stroke and myocardial infarction. The aim of this study was to determine the association of MPV with the development of stoke in patients with atrial fibrillation (AF). MPV, N-terminal pro B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hsCRP) were analysed in 200 patients with AF (mean age 69 years; 56% male). The primary endpoint was ischaemic stroke event. The mean MPV was 8.5?±?1.0?fL and the median NT-proBNP was 1916.5 (IQR 810-4427) pg/mL. The median hsCRP was 0.47 (IQR 0.32-2.46)?mg/dL. There were 14 stroke events during a mean of 15.1 months of follow up. Kaplan-Meier analysis revealed that the higher tertile MPV group (≥8.9 fL) had a significantly higher stroke rate compared to the lower tertile MPV group (<8.0 fL) (14.7% vs. 3.1%, log-rank: P?=?0.01). A higher MPV was an independent predictor of stroke risk after adjusting for age, gender, and other CHADS(2) (congestive heart failure, hypertension, diabetes, and previous stroke or transient ischemic attack (TIA) history) score components (hazard ratio: 5.03, 95% CI 1.05-24.05, P?=?0.043) in Cox proportional hazard analysis. When the MPV cut-off level was set to 8.85 fL using the receiver operating characteristic curve, the sensitivity was 71% and the specificity was 69% for differentiating between the group with stroke and the group without stroke. This value was more useful in patients with a low to intermediate traditional thromboembolic risk (CHADS(2) score <2). Furthermore, AF patients with an MPV over 8.85 fL had high stroke risk without anticoagulation, especially in the low thromboembolic risk group (Log-Rank <0.0001). The results of this study show that MPV was a predictive marker for stroke; its predictive power for stroke was independent of age, gender, and other CHADS(2) score components in patients with AF. These findings suggest that anticoagulation may be needed in patients with a high MPV, even if they have low to intermediate traditional thromboembolic risk (CHADS(2) score <2).     

Usefulness of mean platelet volume as a biomarker for long-term outcomes after percutaneous coronary intervention

Larger size platelets have enhanced reactivity. The mean platelet volume (MPV) is a marker of platelet activation and is usually measured as part of blood testing. The aim of the present study was to investigate the utility of the MPV as a biomarker in prognosticating the long-term outcomes after percutaneous coronary intervention (PCI). The baseline MPV values from consecutive patients undergoing PCI were screened. Of the 1,432 patients, the composite primary end point of mortality or myocardial infarction at 1 year occurred in 80 (5.6%). The patients in the highest tertile (MPV >9.1 fL) had an increased frequency of the primary end point compared to those in the mid (8.1 to 9.1 fL) and lowest (<8.1 fL) tertiles (9.0%, 4.5%, and 3.5%, respectively; p <0.01). Logistic regression analysis demonstrated diabetes (odds ratio 2.44, 95% confidence interval 1.48 to 4.00) and highest tertile of MPV (odds ratio 2.42, 95% confidence interval 1.47 to 3.99) as the best predictors of adverse outcomes. In patients with acute coronary syndrome, the preprocedural MPV and troponin levels demonstrated a comparable predictive relation to the primary end point (receiver operator characteristics curve analysis, area under the curve 0.64, p = 0.01; and 0.63, p = 0.01, respectively). In conclusion, an elevated MPV was a strong independent predictor of long-term outcomes after PCI. The preprocedural MPV had prognostic value similar to that of troponin in patients with acute coronary syndrome. These findings could be of importance in the clinical evaluation of patients before PCI and the design of future studies assessing antiplatelet therapies.     

Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: a systematic review and meta-analysis

The aim of this study was to elucidate the diagnostic and prognostic roles of the mean platelet volume (MPV) in various malignant tumors through a systematic review and meta-analysis. The current study included 2,053 patients and 1,396 healthy subjects in 18 eligible studies. We performed a meta-analysis of MPV levels and the mean difference between healthy subjects and pre- and post-treatment patients. Subgroup analysis was conducted based on specific organs and platelet counts. In addition, the correlation between MPV and survival was investigated. The pooled MPVs of healthy subjects, pre-treatment, and post-treatment patients were 8.428 fL (95% confidence interval [CI] 8.118–8.738), 8.831 fL (95% CI 8.582–9.087), and 8.521 fL (95% CI 8.162–8.880), respectively. The mean difference in MPV between healthy subjects and pre-treatment patients was 0.502 (95% CI 0.285–0.719, P < 0.001). However, in lung cancer, the mean difference between pre-treatment patients and healthy subjects was ?0.352 (95% CI ?0.763–0.060, P = 0.094). The pooled MPV of post-treatment patients was significantly decreased compared to pre-treatment patients. There was no correlation between MPV and disease-free survival rate (hazard ratio 1.033, 95% CI 0.369–2.895). Our results showed that the MPV level was significantly higher in malignant tumors than in healthy subjects and was decreased after treatment. Further cumulative studies will be required before MPV levels can be applied for screening malignant tumors and predicting prognosis.     

Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention

OBJECTIVES: We sought to determine the prognostic value of mean platelet volume (MPV) for angiographic reperfusion and six-month mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). BACKGROUND: Mean platelet volume is predictive of unfavorable outcome among survivors of STEMI when measured after the index event. No data are available for the value of admission MPV in patients with STEMI treated with primary PCI. METHODS: Blood samples for MPV estimation, obtained on admission in 398 consecutive patients presenting with STEMI, were measured before primary PCI. Follow-up up to six months was performed. RESULTS: No-reflow was significantly more frequent in patients with high MPV (> or =10.3 fl) compared with those with low MPV (<10.3 fl) (21.2% vs. 5.5%, p < 0.0001). The MPV was correlated strongly with corrected Thrombolysis In Myocardial Infarction frame count (CTFC) (r = 0.698, p < 0.0001). Kaplan-Meier survival analysis showed six-month mortality rate of 12.1% in patients with high MPV versus 5.1% in low MPV group (log rank = 6.235, p = 0.0125). After adjusting for baseline characteristics, high MPV remained a strong independent predictor of no-reflow (odds ratio [OR] 4.7, 95% confidence interval [CI] 2.3 to 9.9, p < 0.0001), CTFC > or =40 (OR 10.1, 95% CI 5.7 to 18.1, p < 0.0001), and mortality (OR 3.2, 95% CI 1.1 to 9.3, p = 0.0084). Abciximab administration resulted in significant mortality reduction only in patients with high MPV values (OR 0.02, 95% CI 0.01 to 0.48, p = 0.0165). CONCLUSIONS: Mean platelet volume is a strong, independent predictor of impaired angiographic reperfusion and six-month mortality in STEMI treated with primary PCI. Apart from prognostic value, admission MPV may also carry further practical, therapeutic implications.     

营养支持联合美他多辛治疗酒精性肝病患者肝功能和外周血细胞参数的变化

目的 探讨营养支持联合美他多辛治疗酒精性肝病患者对肝功能、红细胞和血小板参数的影响。方法 2015年5月~2017年10月我院诊治的酒精性肝病患者90例,被分为两组,每组45例,分别给予美他多辛片或美他多辛联合营养支持治疗4周,后者为给予35~40 kcat·kg^-1·d^-1的热量。结果 治疗前,两组肝功能指标差异无统计学意义（P>0.05）,治疗结束时,两组血清ALT、GGT和TBIL水平明显降低,ALB明显升高;治疗前,两组凝血功能指标差异无统计学意义（P>0.05）,治疗后两组PT、APTT和TT均明显缩短,FIB显著升高;治疗前,两组红细胞参数和血红蛋白水平差异无统计学意义（P>0.05）,治疗后两组RBC、HGB和HCT均显著上升,RDW和MCV显著下降;治疗前,两组血小板计数（PLT）、血小板平均体积（MPV）和血小板分布宽度（PDW）相比无统计学差异（P>0.05）,治疗后PLT显著上升,MPV和PDW明显降低（P<0.05）,联合组以上变化均显著优于对照组（P<0.05）。结论 营养支持联合美他多辛治疗酒精性肝病患者能够显著改善肝功能、凝血功能、红细胞和血小板参数,提示营养支持治疗可能更重要,需要高度重视。     

Increased platelet activation in young patients with prehypertension

Mean platelet volume (MPV) and sP-selectin levels are considered as indicators of platelet activation. In this study, we assessed platelet activation in prehypertensive patients by comparing MPV and sP-selectin levels of these patients with healthy conrols. The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age = 34 ± 6 y) and 25 healthy control subjects (16 men, mean age = 33 ± 6 y) eligible for the current study. Blood pressure (BP) , lipid profile, plasma glucose, HOMA-IR values, sP-selectin levels, platelet counts, and MPV were measured in both groups. Other than systolic blood pressure (SBP) and diastolic blood pressure (DBP), baseline demographic characteristics of both groups were similar. No significant difference was found between the platelet counts of the two groups. Despite comparable platelet counts, platelet activation parameters were found significantly higher in the prehypertensives. Prehypertensives had larger a MPV value compared to that of the control group (8.24 ± 0.46 fl vs. 7.70 ± 0.64 fl; P = 0.001) and plasma sP-selectin levels were also significantly higher in the prehypertensive patients (163.60 ± 41.21 ng/ml vs. 132.80 ± 36.46; P = 0.007). Spearman correlation analysis revealed moderate positive correlation between SBP and platelet activation parameters (for SBP and MPV, r = 0.60, p = 0.001; for SBP and sP-selectin r = 0.51, p = 0.009). Prehypertension causes platelet activation as evidenced by increased MPV and plasma sP-selectin levels. Increased platelet activation might be related to increased vascular thrombotic risk in those patients.     

Hematologic parameters and angiographic progression of coronary atherosclerosis

Hematologic parameters have prognostic importance in cardiovascular disease. However, the relation between atherosclerosis progression and hematologic parameters is not well defined. A total of 394 patients requiring repeat coronary angiography were included in the study. According to angiography, patients were divided into 2 groups, progressive (n = 196) and nonprogressive (n = 198) diseases. Hematologic parameters including mean platelet volume (MPV) and neutrophil/lymphocyte (N/L) ratio were measured. Glucose, creatinine, and cholesterol were significantly higher in the progressive group. Mean platelet volume count was similar in both groups. The N/L ratio was significantly higher in the progressive group (5.0 ± 5.1 vs 3.2 ± 3; P = .001). In multivariate analysis, the N/L ratio was significantly related with progression (relative risk [RR]: 2.267, 95% CI: 1.068-4.815, P = .03). Progression rate was significantly high in patients with high N/L ratio (39% vs 56%). Our results suggest that the N/L ratio is a predictor of progression of atherosclerosis.