血小板参数对骨髓增殖性肿瘤患者动脉并发症的预测价值  

Predictive Value of Platelet Parameters for Arterial Complications in Patients with Myeloproliferative Neoplasms

作　　者：赵森[1] 陈烨[1] 任修文 ZHAO Sen;CHEN Ye;Ren Xiu-Wen(Department of Hematology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100069,China;School of Public Health,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安贞医院血液科,北京100029 [2]首都医科大学公共卫生学院,北京100069

出　　处：《中国实验血液学杂志》2025年第1期198-205,共8页Journal of Experimental Hematology

摘　　要：目的:通过分析真性红细胞增多症(PV)及原发性血小板增多症(ET)患者动脉事件发生情况和血小板参数水平,探讨骨髓增殖性肿瘤(MPN)患者的血小板参数特点及其与动脉并发症的关系。方法:回顾性分析2017年8月至2022年8月于首都医科大学附属北京安贞医院血液内科初诊的PV、ET患者的临床和实验室资料。结果:入选86例MPN患者,其中PV 44例、ET 42例,男性46例、女性40例,中位发病年龄61(23-83)岁。PV患者的JAK2V617F基因突变率、骨髓巨核细胞数量、脾肿大的发生率,以及WBC、HGB、HCT、PDW、MPV、P-LCR水平均明显高于ET患者(P<0.05),PLT和PCT水平显著低于ET患者(P<0.01)。22例(50%)PV患者合并动脉事件,其中≥2个部位发生动脉狭窄者12例,动脉事件中,合并缺血性脑卒中的PV患者PDW高于无缺血性脑卒中的PV患者(P=0.003),≥2个部位发生动脉狭窄的PV患者PDW高于≤1个部位动脉狭窄的PV患者(P=0.037)。23例(54.8%)ET患者合并动脉事件,≥2个部位发生动脉狭窄者7例,动脉事件中,合并缺血性脑卒中的ET患者PCT高于无缺血性脑卒中的ET患者(P=0.037),≥2个部位发生动脉狭窄的ET患者PCT高于≤1个部位动脉狭窄的ET患者(P=0.049)。二元logistic回归分析结果显示,PDW、PCT升高分别是PV、ET患者发生缺血性脑卒中的危险因素(P<0.05)。结论:PV和ET患者的血小板参数具有明显不同的特点,PDW和PCT升高分别预示着PV和ET患者发生缺血性脑卒中的风险较高。Objective:To analyze the occurrence of arterial events and platelet parameters in patients with polycythemia vera(PV)and essential thrombocythemia(ET),and to explore the characteristics of platelet parameters in patients with PV and ET and their relationship with arterial complications.Methods:The clinical and laboratory data of newly diagnosed PV and ET patients who visited the Department of Hematology,Beijing Anzhen Hospital,Capital Medical University from August 2017 to August 2022 were retrospectively analyzed.Results:86 MPN patients(46 males and 40 females)were enrolled,including 44 PV patients and 42 ET patients,with an median age of 61(23-83)years.The mutation rate of JAK2V617F gene,the number of megakaryocytes in bone marrow,the incidence of splenomegaly,and the levels of white blood cell count(WBC),hemoglobin(HGB),hematocrit(HCT),platelet distribution width(PDW),mean platelet volume(MPV),platelet-large cell ratio(P-LCR)in PV patients were significantly higher than those in ET patients(P<0.05),while the levels of PLT and PCT were significantly lower than those in ET patients(P<0.01).22 cases(50%)of PV patients were complicated with arterial events,of which 12 had arterial stenosis in≥2 locations.Among arterial events,the PDW of PV patients with ischemic stroke was greater than that of PV patients without ischemic stroke(P=0.003),and the PDW of PV patients with arterial stenosis in≥2 locations was greater than that of PV patients with arterial stenosis in≤1 location(P=0.037).23 cases(54.8%)of ET patients were complicated with arterial events,and 7cases had arterial stenosis in≥2 locations.In arterial events,the PCT of ET patients complicated with ischemic stroke was greater than that of ET patients without ischemic stroke(P=0.037),and the PCT of ET patients with≥2 locations of arterial stenosis was greater than that of ET patients with≤1 location of arterial stenosis(P=0.049).The binary logistic regression analysis showed that elevated PDW and PCT were risk factors for ischemic stroke in PV and

关 键 词：真性红细胞增多症 原发性血小板增多症 动脉事件 缺血性脑卒中 血小板参数 

分 类 号：R733.3[医药卫生—肿瘤]