缺血性脑血管病血小板形态变化的临床观察

目的探讨血小板形态在脑梗死发病中的变化及作用。方法观察缺血性脑血管病(ICD)短暂性脑缺血发作(TIA)、急性进展型缺血性脑卒中、急性稳定型缺血性脑卒中患者及健康对照组的血小板计数(PLT)、血小板平均体积(MPV)和血小板体积分布宽度(PDW)。结果脑梗死急性期PLT明显低于TIA组和健康对照组(P<0.05,P<0.01),TIA组低于健康对照组(P<0.05);脑梗死急性期MPV和PDW明显高于TIA组和健康对照组(P<0.01),TIA组高于健康对照组(P<0.01);急性进展型缺血性脑卒中PLT低于急性稳定型缺血性脑卒中(P<0.01),MPV和PDW高于急性稳定型缺血性脑卒中(P<0.01)。结论血小板的形态在脑梗死之前就发生变化,动态观察血小板3项参数对脑梗死的预防、诊断及判断预后有指导意义。

Clinical observation on the morphological changes of platelet in patients with ischemic cerebrovascular diseases

Objective To investigate the changes and effects of platelet form in patients with cerebral infarction.Methods The platelet counts,mean platelet volume and platelet distribution width in patients with ischemic cerebrovascular diseases(ICD)including transient ischemic attack(TIA),acute deteriorative ischemia and acute stable ischemic stroke and in healthy subjects(control group)were detected.Results The platelet counts at acute phase in patients with cerebral infarction were significantly lower than those in transient ischemic attack and in control group(P<0.05 or P<0.01),and which in transient ischemic attack were lower than those in control group(P<0.05).The mean platelet volume and platelet distribution width at acute phase in patients with cerebral infarction were significantly higher than those in transient ischemic attack and in control group(P<0.01),and which in transient ischemic attack were obviously higher than those in control group(P<0.01).The platelet counts in acute deteriorative ischemia were significantly lower than those in acute stable ischemic stroke(P<0.01),and mean platelet volume and platelet distribution width were remarkably higher than those in acute stable ischemic stroke(P<0.01).Conclusion The platelet has changed before the occurrence of cerebral infarction,and dynamic observation on three parameters of platelet have directive significance for the prevention,diagnosis and predict prognosis in patients with cerebral infarction.