脑梗死患者血小板参数的测定及临床意义

目的检测脑梗死患者外周血的血小板参数,研究脑梗死发病后不同时间段及不同梗死面积的血小板参数变化,为临床应用抗血小板聚集治疗脑梗死提供理论依据。方法应用全自动血细胞分析仪,对97例脑梗死患者及40例健康体检者进行血小板参数(主要指血小板计数、血小板平均体积、血小板分布宽度)检测,按不同发病时间段分为<48 h内组(20例)、49 h~7 d组(33例)、7~14 d天组(11例),14 d后组(33例);按梗死面积不同分为腔隙性脑梗死组(39例)、小面积梗死组(29例)、大面积梗死组(29例)。对各组与对照组间及各组之间的血小板参数进行比较。结果脑梗死患者急性期外周血血小板计数(Plt)降低,血小板平均体积(MPV)、血小板分布宽度(PDW)升高。发病48h内Plt显著减少(P<0.01),7~14d及>14d逐渐恢复正常(P>0.05);发病48 h内MPV及PDW显著升高(P<0.01),49 h~7 d达高峰,之后逐渐降低,但至14 d后仍高于正常水平(P<0.05)。脑梗死面积越大,患者Plt越低(P<0.05),MPV、PDW越高(P<0.05)。结论在动脉粥样硬化及脑梗死患者中动态监测血小板参数的变化,有助于脑梗死的预防及预后的判断。

The significance of the varitions of platelet parameters in cerebral infarction patients

Objective To study the regularity and significance of the variations of the platelet parameters in cerebral infarction(CI) during different period and infarct size and provide theoretical basis the anti-platelet aggregation treatment.Methods 97 cases with cerebral infarction and 40 healthy participants were detected the platelet parameters by automatic hematology analyzer.They were divided into four groups by different periods(<48 hours,49 h～7 days,7～14 days and >14 days) and divided into three groups by the infarct size(large size small size and lacunar CI).The study selectes the CI patients(CI group) and the healthy physical examinees(control group) in the same hospital and during the same interval.With regard to platelet study group:In terms of time of incidence(in 48h,49h～7d,7～14d and after 14d) and infarct size(large size small size and lacunar CI).We separate the CI group into different subgroups,each subgroup were compared with control separately,and also make group comparison between platelet group.Results The PLT is the lowest in 48h after CI onset,but ascend gradually with the time developed,and recovered to normal level at the 14 days post currently(P<0.05).Comparing with control group,MPV and PDW ascend markedly in 48h after CI onset(P<0.05)and reach the peaks at the time of 48h~7d,then descend gradually,but even higher than control group at the recovery period(P<0.05).The larger the infarct size is,the lower the PLT is,and the higher the MPV、PDW are.Conclusion Detecting the platelet parameters of patients with CI and atherosclerosis is valuable for the judgment of the prevention and prognosis.