血小板参数与冠心病患者冠状动脉病变程度相关性研究

目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者入院时血小板相关参数与冠状动脉病变程度之间的相关性。方法回顾性分析蚌埠医学院第一附属医院心血管内科2013年3月~2013年9月诊断为不稳定型心绞痛并行冠状动脉造影术的患者198例,其中男性128例,女性70例,平均年龄(64±11)岁。选取冠状动脉造影正常者为对照组(50例),剩余根据病变范围分为单支组(51例)、双支组(49例)和多支组(48例);根据Gensini评分分为20组(55例),20~40组(58例),40组(35例)。检测所有患者血小板相关参数、冠脉病变支数及Gensini评分。结果四组患者血小板计数、大型血小板比率和血小板压积比较,差异无统计学意义(P均0.05)。与对照组比较,单支组、双支组和多支组血小板分布宽度呈增高趋势,血小板平均体积均下降,差异具有统计学意义(P均0.05)。与对照组比较,20组、20~40组和40组血小板平均体积、血小板分布宽度均升高,差异具有统计学意义(P均0.05)。血小板平均体积、血小板分布宽度均与冠状动脉病变支数呈正相关,相关系数分别为0.211、0.221,有统计学意义(P均0.05)。血小板分布宽度及血小板平均体积与冠状动脉造影Gensini评分呈正相关,相关系数分别为0.239、0.219,有统计学意义(P均0.05)。结论联合检测血小板平均体积及血小板分布宽度水平对判断冠状动脉病变程度具有重要指导意义。

Correlation between platelet parameters and coronary lesion severity in patients with coronary heart disease

Objective To investigate the correlation between related platelet parameters and coronary lesion severity in patients with coronary heart disease （CHD）.Methods The patients （n=198, male 128, female 70 and average age=64±11） with unstable angina pectoris （UAP） undergone coronary angiography （CAG） were analyzed retrospectively from Mar. 2013 to Sept. 2013. They were divided into control group （n=50）, 1-vessel group （n=51）, 2-vessel group （n=49） and multi-vessel group （n=48） according to the outcomes of CAG, and divided again into〈20 group （n=55）, 20-40 group （n=58） and 〉40 group （n=35） according to Gensini scores. The related platelet parameters, lesion number of coronary vessels and Gensini scores were detected in all patients.Results The difference in platelet count, P-LCR and thrombocytocrit had no statistical significance among 4 groups （allP〉0.05）. Compared with control group, in 1-vessel group, 2-vessel group and multi-vessel group platelet distribution width （PDW） showed an increasing trend, and mean platelet volume （MPV） decreased （allP〈0.05）. Compared with control group, in 〈20 group, 20-40 group and 〉40 group MPV and PDW increased （allP〈0.05）. MPV （RSD=0.211） and PDW were positively correlated to lesion number of coronary vessels （RSD=0.221, allP〈0.05）. PDW （RSD=0.239） and MPV （RSD=0.219） were positively correlated to Gensini scores （allP〈0.05）.Conclusion Combined detection of MPV and PDW has an important significance to judge the severity of coronary artery disease.