4项血小板参数检测在慢性心力衰竭诊疗中临床价值

目的:探讨慢性心力衰竭(chronic heart failure,CHF)患者血小板参数的变化及其临床意义。方法:采用XE-2100型血细胞分析仪检测CHF患者65例及健康体检者30例4项血小板参数,包括血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、大血小板比率(P-LCR)。根据美国纽约心脏病协会(NYHA)心功能分级方案对CHF患者进行心功能分级。结果:(1)CHF患者MPV、PDW和P-LCR,均明显高于健康对照组(P<0.05);而PLT比较差异无统计学意义(P>0.05)。(2)CHF患者MPV、PDW随着NYHA心功能分级Ⅱ~Ⅳ级逐渐升高,NYHAⅡ~Ⅳ级各自的MPV、PDW比较,差异均有统计学意义(P<0.05);而PLT及P-LCR各级之间比较差异无统计学意义(P>0.05)。(3)NYHA分级与MPV间呈正相关,相关系数r=0.613,P<0.05。NYHA分级与PDW间也呈正相关,相关系数r=0.683,P<0.05。结论:血小板参数测定可作为CHF患者心功能评价较好的指标,其中MPV、PDW为更灵敏的指标,与心力衰竭严重程度密切相关。

The clinical significance of platelet parameters in patients with chronic heart failure

Objective:To investigate platelet parameters of patients with chronic heart failure(CHF) and its clinical significance.Methods:XE-2100 hematology analyzer was used to detect the platelet parameters such as platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW) and platelet-large cell ratio(P-LCR) in 65 patients with CHF and 30 cases of healthy people.Cardiac function of patients with CHF was graded according to the New York Heart Association(NYHA) class program.Results:MPV,PDW and P-LCR of CHF patients were significantly higher than in the control group(P<0.05);whereas,PLT had no significantly change,compared with control group(P>0.05).The MPV and PDW of NYHA class II to class IV CHF patients were increased gradually and there were statistically significant differences among the NYHA class II,class III,class IV groups(P<0.05),but PLT and P-LCR had no statistical differences among the NYHA class II,class III,class IV groups(P>0.05).MPV and PDW had obviously positive correlation with NYHA classification(MPV,r=0.613,P<0.05,PDW,r=0.683,P<0.05).Conclusion:Platelet parameters can be used as a sensitive indicator to evaluate the cardiac function of CHF patients,especially the MPV and PDW closely related with the severity of heart failure.