急性脑梗死患者不同MS组分对其血小板聚集功能的影响及相关性研究

The effect of different components of metabolic syndrome on platelet aggregation and its correlation in patients with acute cerebral infarction

目的探讨急性脑梗死(ACI)患者不同代谢综合征(MS)组分对其血小板聚集功能(PA)的影响及相关性。方法选取徐州医科大学附属医院住院的ACI患者152例。根据MS诊断标准,将88例合并MS的患者作为观察组(MS组),未患有MS的患者64例为对照组(非MS组),比较2组患者的临床特征和血小板聚集功能。进一步根据MS定义中代谢异常组分的累加评分(0~4分)将ACI患者分为5组,比较各组间血小板聚集功能变化以及不同MS组分与血小板聚集功能的相关性。结果MS组与非MS组患者二磷酸腺苷(ADP)诱导血小板聚集率(ADP%)的组间差异有统计学意义(P<0.05)。与非MS组比较,MS组甘油三酯(TG)、空腹血糖(FGB)、糖化血红蛋白(HbA1c)、收缩压(SBP)、舒张压(DBP)及腰围和体重明显升高,高密度脂蛋白胆固醇(HDL-C)明显降低的差异(P<0.05)。单因素方差分析显示,随着MS组分聚集的增加,ADP%逐渐升高,差异具有统计学意义(P<0.05);多元线性回归分析显示,FGB、TG、腰围与ADP%呈显著正相关,HDL-C与ADP%呈显著负相关(P<0.05)。结论ACI合并MS患者较不合并MS患者具有更高的ADP%。FGB、TG、腰围及HDL-C是ACI患者ADP%升高的重要预测因子。随着MS组分聚集的增加,其对ACI患者血小板聚集功能影响产生累计作用。

Objective To study the effect and correlation of the components of different metabolic syndrome(MS)on the platelet aggregation function(PA)in patients with acute cerebral infarction(ACI).Methods A total of 152 patients with ACI hospitalized in the Affiliated Hospital of Xuzhou Medical University were selected.According to the MS diagnostic criteria,88 patients with MS were assigned to an observation group(MS group),and 64 patients without MS were assigned to a control group(non-MS group).The clinical characteristics and platelet aggregation function of the two groups were compared.The patients with ACI were further divided into 5 groups according to the cumulative score(0-4 points)of metabolic abnormality components in MS definition.The changes of platelet aggregation function and the correlation between different MS components and platelet aggregation function were compared.Results The difference of ADP induced platelet aggregation rate(ADP%)between MS group and non-MS group was statistically significant(P<0.05).Compared with the non-MS group,triglyceride(TG),fasting blood glucose(FGB),glycated hemoglobinA1c(HbA1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),waist circumference and body weight were significantly increased,while high-density lipoprotein cholesterol(HDL-C)was significantly decreased(P<0.05).One-way ANOVA showed that with the increase of MS component aggregation,ADP%gradually increased,the difference was statistically significant(P<0.05);multiple linear regression analysis showed that FGB,TG,waist circumference and ADP%were positively correlated,while HDL-C and ADP%were negatively correlated(P<0.05).Conclusions Patients with ACI and MS have higher platelet aggregation rate than those without MS.FGB,TG,waist circumference and HDL-C are important predictors of platelet aggregation in patients with ACI.With the increase of MS component aggregation,it has cumulative effect on platelet aggregation in ACI patients.