冠心病并高血压患者平均血小板体积变化及其临床意义研究

Change and Clinical Significance of Mean Platelet Volume in Coronary Heart Disease Patients Complicated with Hypertension

目的分析冠心病并高血压患者平均血小板体积(MPV)变化及其临床意义。方法选取2014—2015年武汉大学人民医院心内科收治的冠心病患者233例,根据是否合并高血压分为A组(未合并高血压,n=80)和B组(合并高血压,n=153)。比较两组患者一般资料、血常规和血生化检查指标、冠状动脉病变情况,比较不同临床特征冠心病并高血压患者MPV,冠心病并高血压患者MPV的相关因素分析采用多元线性回归分析。结果 B组患者男性比例、吸烟率和饮酒率低于A组,年龄大于A组(P<0.05);两组患者糖尿病发生率和冠心病类型比较,差异无统计学意义(P>0.05)。两组患者血红蛋白(Hb)、血小板计数(PLT)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、清蛋白(Alb)、尿素氮(BUN)、肌酐(Cr)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)比较,差异无统计学意义(P>0.05);B组患者白细胞计数(WBC)低于A组,MPV大于A组,尿酸(UA)高于A组(P<0.05)。两组患者冠状动脉病变支数和Gensini积分比较,差异有统计学意义(P<0.05)。不同性别、有无糖尿病、是否饮酒、不同冠心病类型的冠心病并高血压患者MPV比较,差异无统计学意义(P>0.05);是否吸烟、不同冠状动脉病变支数及高血压分级的冠心病并高血压患者MPV比较,差异有统计学意义(P<0.05)。多元线性回归分析结果显示,三支病变(回归系数=0.156)、Gensini积分(回归系数=0.020)分别与冠心病并高血压患者MPV呈正相关(P<0.05);与高血压1级比较,高血压2级(回归系数=0.321)、高血压3级(回归系数=0.457)分别与冠心病并高血压患者MPV呈正相关(P<0.05)。结论冠心病并高血压患者MPV增大,且MPV与冠状动脉病变严重程度和高血压严重程度独立相关。

Objective To analyze the change and clinical significance of mean platelet volume （MPV） in coronary heart disease patients complicated with hypertension. Methods From 2014 to 2015, a total of 233 patients with coronary heart disease were selected in the Department of Cardiology, the People＇s Hospital of Wuhan University, and they were divided into A group （ did not complicate with hypertension, n = 80） and B group （ complicated with hypertension, n = 153 ） according to the incidence of hypertension. General information, blood routine examination and blood biochemical examination results, and coronary artery lesion status were compared between the two groups; MPV of B group was compared in patients with different clinical features, and related factors of MPV were analyzed by multiple linear regression analysis in coronary heart disease patients complicated with hypertension. Results Male ratio, smoking rate and drinking rate of B group were statistically significantly lower than those of A group, while age of B group was statistically significantly older than that of A group （ P 〈 0.05 ） ; no statistically significant differences of incidence of diabetes or coronary heart disease types was found between the two groups （ P 〉 0.05）. No statistically significant differences of lib, PLT, ALT, AST, Alb, BUN, Cr, TC, TG, HDLor LDLwas found between the two groups （ P 〉 0. 05 ） ; WBC of B group was statistically significantly lower than that of A group, MPV of B group was statistically significantly larger than that of A group, while UA of B group was statistically significantly higher than that of A group （P 〈 0. 05 ）. There were statistically significant differences of number of stenosed coronary vessels and Gensini score between the two groups （ P 〈 0. 05）. Of B group, no statistically significant differences of MPV was found in patients with different gender, with or without diabetes, with or without drinking, with different coronary heart disease types （ P 〉0. 05 ）, while there were statistically significant differences of MPV in patients with or without smoking, with different number of stenosed coronary vessels, with different hypertension grading （P 〈0. 05）. Multiple linear regression analysis results showed that, triple - vessel lesions （ regression coefficient was 0. 156 ） and Gensini score （ regression coefficient was 0. 020 ） was positively correlated with MPV in coronary heart disease patients complicated with hypertension, respectively （P 〈 0. 05 ） ; compared with 1 - grade hypertension grading, 2 - grade hypertension grading （ regression coefficient was 0. 321 ） and 3 - grade hypertension grading （regression coefficient was 0. 457） was positively correlated with MPV in coronary heart disease patients complicated with hypertension, respectively （P 〈 0. 05 ）. Conclusion MPV significantly enlarged in coronary heart disease patients complicated with hypertension, and MPV is independently correlated with coronary artery lesion severity and hypertension severity, respectively.