皮质下缺血性血管病患者平均血小板体积水平变化及其意义

On the mean platelet volume level in patients with subcortical ischemic vascular disease

目的探讨皮质下缺血性血管病(SIVD)患者平均血小板体积(MPV)水平的变化及其意义。方法选取340例SIVD患者(SIVD组)和同期健康体检者(对照组)160例,根据头颅MRI将SIVD组分为多发性腔隙性脑梗死(LI)组(n=124)和脑白质疏松(LA)组(n=216),按照Fazekas的评分标准将LA组LA严重程度分为3级;采用血液分析仪检测所有受试者MPV值,比较SIVD组及其亚组与对照组之间MPV水平的变化,并分析MPV与LA程度的相关性。结果SIVD组MPV水平显著高于对照组,差异有统计学意义(P<0.01)。在校正年龄因素后,LI组和LA组MPV水平均显著高于对照组,差异有统计学意义(P<0.01),且LA组MPV水平显著高于LI组,差异有统计学意义(P<0.05)。将LA组进一步分组后显示,LA等级越高者,MPV水平越高,差异有统计学意义(P<0.05);相关分析显示,MPV水平与LA等级呈显著正相关性(r_s=0.596,P<0.01)。多元回归分析显示,在控制各项危险因素后,MPV水平与SIVD的发病仍密切相关(OR=3.461,95%CI:2.653~4.515,P<0.01)。结论 MPV增高可能是SIVD的独立危险因素,且MPV水平与LA严重程度密切相关。

Objective To explore the change and value of mean platelet volume （MPV） level in patients with subcortical isehemie vascular disease （SIVD）. Methods A total of 340 patients with SIVD （ SIVD group） and 160 healthy individuals （the control group） were enrolled into this study. According to magnetic resonance imaging （MRI）, the SIVD group was further devided into two subtypes： lacunar infarction （LI） （n = 124）and leukoaraiosis （LA） （n = 216）. The severity of LA was further graded according to the Fazekas scale. The level of MPV was ex- amined by the hematology analyzer in all subjects. The MPV levels between the subtypes of SIVD and the controls were compared and the relationship between MPV and the severity of LA was analyzed. Results The level of MPV in SIVD was significantly higher than those in the healthy control （P 〈0. 01 ）. In comparison with the controls,the MPV level was significantly higher in both LI and LA subgroups （ P 〈 0.01 ）. Moreover, the MPV level in LA subgroup was significantly higher than those in the LI subgroup （ P 〈 0.05 ）. Meanwhile, with the severity of LA ag- gravated, MPV level increased significantly （ P 〈 0.05 ）. The level of MPV was positive with the severity of LA （ rs = O. 596,P 〈 0. 01 ）. Multivariate logistic regression analysis revealed that MPV level was still closely related with SIVD （ OR=3.461,95% CI：2. 653 -4. 515 ,P 〈 0. 01 ） after controlling for various factors. Conclusion The increased MPV level is an independent risk factor of SIVD and closely related with the severity of LA.