平均血小板体积和血小板聚集率与急性冠状动脉综合征患者支架内血栓的相关性研究  

Clinical outcome prediction from mean platelet volume and platelet aggregation in patients with acute coronary syndrome

作　　者：彭瑜[1] 张钲[1] 白明[1] 潘晨亮[1] 唐宇宁[1] 蔡玮婷 乔鑫[1] 丁丽琼[1] 

机构地区：[1]兰州大学第一医院心脏中心,甘肃兰州730000

出　　处：《中国介入心脏病学杂志》2015年第2期75-79,共5页Chinese Journal of Interventional Cardiology

基　　金：国家重点临床科室项目(2013);甘肃省重点实验室项目(2012);甘肃省自然科学基金项目(1308RJZA208)

摘　　要：目的探讨平均血小板体积（MPV）和血小板聚集率与急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后主要不良心血管事件（MACE）及支架内血栓的相关性。方法连续入选ACS并行PCI患者1425例,根据入院时MPV水平三分位分组：低MPV组（T1组）,MPV≤11.0 fL,477例;中MPV组（T2组）,MPV 11.0-12.1 fL,448例;高MPV组（T3组）,MPV〉12.1 fL,500例。通过单因素分析及Cox回归分析确定MACE的预测因素。结果 ACS患者PCI术后12个月累计MACE发生率为4.42%,Cox分析结果显示高MPV值（OR 1.46,95%CI 1.06-2.01）与血小板抵抗（OR 2.31,95%CI 1.40-3.80）是12个月MACE的独立预测因素（P〈0.05）。高MPV值与血小板抵抗和支架内血栓的发生显著相关（P〈0.05）,且两者间存在微弱的正相关。结论 MPV与血小板对ADP反应性是ACS患者PCI术后远期MACE的预测因素,并与支架内血栓的发生相关。Objective Increased mean platelet volume（ MPV） and Adenosine diphosphate（ ADP）-induced platelet aggregation（ PA） were considered as indicators of platelet function and associated with poor clinical outcome in patients with acute coronary syndrome（ ACS）. The aim of this study was to evaluate their long-term prognostic value in ACS. Methods 1425 patients with ACS were included in our study from 2012 to 2014. All the patients underwent successful primary percutaneous coronary intervention（ PCI） and were divided into three tertiles based on MPV value（ ≤11. 0 fL,11. 0- 12. 1 fL,≥12. 1 fL）.Correlation of MPV with PA was conducted by Bivariate correlation analysis. Cox regression analysis was performed to assess the predictors for major adverse cardiac event（ MACE）. Results MACE occurred in4. 42% of the ACS patients during 1 year follow up. Cox regression analysis showed that the high MPV value（ OR 1. 46,95% CI 1. 06- 2. 01） and platelet resistance（ OR 2. 31,95% CI 1. 40- 3. 80） were independent predictors of MACE in this cohort. Both of them were related to stent thrombosis. Conclusions High MPV value and platelet resistance were independent predictors of MACE in patients with ACS who underwent PCI. Cumulative incidence of stent thrombosis might be higher in patients with high MPV value and platelet resistance.

关 键 词：急性冠状动脉综合征 平均血小板体积 血小板功能检测 支架内血栓 

分 类 号：R541.4[医药卫生—心血管疾病]