特发性心房颤动患者血小板参数变化及其预后影响因素分析  

Changes of platelet parameters and prognostic factors in patients with idiopathic atrial fibrillation

作　　者：陈斌 许岭平 韩芳旗 CHEN Bin;XULing-ping;HAN Fang-qi(Department of Cardiovascular Medicine,Xianyang Central Hospital,Xianyang 712000,Shaanxi,CHINA)

机构地区：[1]咸阳市中心医院心血管内科,陕西咸阳712000

出　　处：《海南医学》2022年第14期1778-1780,共3页Hainan Medical Journal

基　　金：陕西省创新能力支撑计划项目(编号:2018KJXX-072)。

摘　　要：目的观察特发性心房颤动(AF)患者血小板参数变化,并分析其预后影响因素。方法回顾性分析咸阳市中心医院2019年5~12月收治的80例特发性AF患者的临床资料,其中阵发性心房颤动(PAF)32例(PAF组),慢性AF 48例(慢性AF组),并选取同期年龄匹配体检健康者60例作为对照组,检测各组受检者的血小板参数[血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)],随访患者1年,根据终点事件发生情况分为预后良好组与预后不良组,建立Logistic回归模型分析特发性AF患者预后的影响因素。结果慢性AF组与PAF组患者的PLT分别为(189.43±30.26)×10^(9)/L、(170.26±30.12)×10^(9)/L,明显高于对照组的(154.25±22.75)×10^(9)/L,且慢性AF组患者的PLT明显高于PAF组,差异均具有统计学意义(P<0.05);慢性AF组与PAF组患者的MPV[(11.85±1.74)fL、(9.95±1.52)fL]、PDW[(18.75±2.57)%、(17.02±2.46)%]明显大于对照组[(8.21±1.36)fL、(15.28±2.24)%],且慢性AF组患者的MPV、PDW明显大于PAF组,差异均有统计学意义(P<0.05);预后良好组患者的PLT为(177.86±29.48)×10^(9)/L,明显低于预后不良组的(198.68±32.42)×10^(9)/L,MPV和PDW分别为(10.80±1.62)fL、(17.63±2.53)%,明显小于预后不良组的(12.35±1.96)fL、(19.93±2.68)%,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,PLT升高及MPV、PDW增大是特发性AF患者预后不良独立危险因素(P<0.05)。结论特发性AF患者(尤其是慢性AF患者)PLT异常升高,MPV与PDW异常增大,为预后不良危险因素。Objective To observe the changes of platelet parameters in patients with idiopathic atrial fibrillation(AF),and analyze their prognostic factors.Methods The clinical data of 80 patients with idiopathic AF who were admitted to Xianyang Central Hospital between May and December 2019 were retrospectively analyzed,including 32 patients with paroxysmal atrial fibrillation(PAF)and 48 patients with chronic AF(chronic AF group).Sixty age-matched healthy people were selected as the control group.The platelet parameters[platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW)]in each group were measured.The patients were followed up for 1 year and then divided into good prognosis group and poor prognosis group according to the occurrence of end-point events.Logistic regression model was established to analyze the prognostic factors of patients with idiopathic AF.Results PLT in the chronic AF group and PAF group was(189.43±30.26)×10^(9)/L and(170.26±30.12)×10^(9)/L,significantly higher than(154.25±22.75)×10^(9)/L in the control group;PLT in the chronic AF group was significantly higher than that in PAF group;the differences were statistically significant(P<0.05).MPV and PDW were(11.85±1.74)fL and(18.75±2.57)% in the chronic AF group,(9.95±1.52)fL and(17.02±2.46)% in PAF group,significantly larger than(8.21±1.36)fL and(15.28±2.24)% in the control group;MPV and PDW in the chronic AF group were significantly larger than those in PAF group;the differences were statistically significant(P<0.05).PLT,MPV,and PDW in the good prognosis group were(177.86±29.48)×10^(9)/L,(10.80±1.62)fL,and(17.63±2.53)%,significantly lower or smaller than(198.68±32.42)×10^(9)/L,(12.35±1.96)fL,and(19.93±2.68)% in the poor prognosis group(P<0.05).Logistic regression analysis found that increased PLT,MPV,and PDW were independent risk factors for poor prognosis of patients with idiopathic AF(P<0.05).Conclusion Patients with idiopathic AF,especially patients with chronic AF,have abnormally increased PLT,MPV and PDW,

关 键 词：特发性心房颤动 血小板计数 血小板平均体积 血小板分布宽度 预后 因素 

分 类 号：R541.75[医药卫生—心血管疾病]