非瓣膜病心房颤动患者平均血小板体积的变化和意义

The changes of mean platelet volume and its significance in non-valvular atrial fibrillation patients

目的观察不同类型非瓣膜病性心房颤动患者的平均血小板体积(MPV)变化和意义。方法 134例心房颤动患者根据心房颤动类型分为阵发性心房颤动组(61例)、持续性心房颤动组(43例)、永久性心房颤动组(30例),选择55例同期就诊的非心房颤动患者为对照组,根据CHA_2DS_2-VASc及HAS-BLED评分对心房颤动患者进行危险分层,检测MPV、C反应蛋白(CRP)、脑钠肽(BNP)及D-二聚体水平,同时行心脏超声检查。结果单因素分析结果提示,持续性及永久性心房颤动组MPV水平显著高于对照组(P<0.05)。多因素logistic回归分析结果提示,在矫正混杂因素后,MPV是心房颤动患者的独立危险因素(OR=1.523,95%CI:1.039~2.235)。在CHA_2DS_2-VASc评分分组中,高危组和中危组MPV水平较低危组显著升高(均P<0.05);在HAS-BLED评分分组中,低危组和高危组间MPV水平无统计学差异(P>0.05)。结论 MPV在持续性和永久性心房颤动患者中显著升高,并与CHA_2DS_2-VASc评分相关。

Objective To explore the change of mean platelet volume(MPV)and its significance in patients with non-valvular atrial fibrillation(AF).Methods 134 AF patients were enrolled and divided into paroxysmal AF group(n=61),persistent AF group(n=43)and permanent AF group(n=30).Risk stratifications were made based on CHA2DS2-VASc and HAS-BLED classification.55 patients without AF were enrolled as control group.The levels of blood MPV,C-reactive protein,brain natriuretic peptide and D-Dimmer were measured,and echocardiography was performed.Results Univariate analysis showed that the levels of MPV in persistent and permanent AF group were significantly higher than that in control group(P<0.05).Multivariate logistic regression analysis showed that MPV was an independent risk factor in patients with AF after correction for confounding factors(OR=1.523,95%CI:1.039~2.235).The level of MPV was significantly higher in both high and middle risk groups than in low risk group based on CHA2DS2-VASc score(all P<0.05),but not significant difference between low risk and high risk groups based on HAS-BLED score.Conclusion MPV increases in patients with persistent and permanent AF and correlates with CHA2DS2-VASc score.