血小板参数与冠心病患者冠状动脉病变程度的关系分析

Correlation between platelet parameters and the severity of coronary artery lesions in patients with coronary heart disease

目的 探讨血小板参数与冠心病患者冠状动脉病变程度的关系。方法 180例初诊或随访的冠心病患者为观察组,以冠状动脉CT血管成像(CCTA)结果不同分为中度狭窄组(95例)和重度狭窄组(85例),选取同时间段CCTA结果阴性的80例患者为对照组。比较三组临床资料[性别、年龄、体质量指数(BMI)、基础疾病(高血压、糖尿病)、吸烟史],血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)],血小板参数[血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板最大聚集率(MAR)]。结果 三组的性别、年龄、BMI、基础疾病(高血压、糖尿病)、吸烟史、 TC、TG、LDL-C比较,差异均无统计学意义(P>0.05)。对照组的PLT、PCT、PDW、MPV、MAR分别为(198.41±32.14)×10^(9)/L、(0.175±0.042)%、(11.12±0.32)%、(7.34±1.11)fl、(53.62±10.36)%,中度狭窄组的PLT、PCT、PDW、MPV、MAR分别为(178.37±36.47)×10^(9)/L、(0.176±0.047)%、(14.34±0.58)%、(9.21±1.12)fl、(63.31±11.13)%,重度狭窄组的PLT、PCT、PDW、MPV、MAR分别为(159.81±37.17)×10^(9)/L、(0.174±0.043)%、(17.98±0.36)%、(11.98±0.79)fl、(75.89±16.98)%。三组PLT、PDW、MPV、MAR比较,差异具有统计学意义(P<0.05);三组PCT比较,差异无统计学意义(P>0.05)。重度狭窄组和中度狭窄组的PDW、MPV、MAR均高于对照组,PLT低于对照组;重度狭窄组的PDW、MPV、MAR均高于中度狭窄组,PLT低于中度狭窄组,差异具有统计学意义(P<0.05)。结论 冠心病患者的血小板参数会异于健康者,可作为判断冠状动脉病变程度的重要指标之一。

Objective To discuss the correlation between platelet parameters and the severity of coronary artery lesions in patients with coronary heart disease.Methods 180 patients with coronary artery disease who were initially diagnosed or followed up were selected as the observation group.According to the results of coronary computed tomography angiography(CCTA),they were divided into moderate stenosis group(95 cases)and severe stenosis group(85 cases),and 80 patients with negative CCTA results in the same time period were selected as the control group.Comparison was made on clinical data[gender,age,body mass index(BMI),underlying diseases(hypertension,diabetes mellitus),smoking history],blood lipid indexes[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)],platelet parameters[platelet count(PLT),plateletcrit(PCT),and mean platelet volume(MPV),platelet distribution width(PDW),maximum aggregation rate(MAR)]among the three groups.Results There was no statistically significant difference in the comparison of gender,age,BMI,underlying disease(hypertension,diabetes mellitus),smoking history,TC,TG,and LDL-C among the three groups(P>0.05).PLT,PCT,PDW,MPV,and MAR in the control group were(198.41±32.14)×10^(9)/L,(0.175±0.042)%,(11.12±0.32)%,(7.34±1.11)fl,and(53.62±10.36)%,respectively;PLT,PCT,PDW,MPV,and MAR in the moderate stenosis group were(178.37±36.47)×10^(9)/L,(0.176±0.047)%,(14.34±0.58)%,(9.21±1.12)fl,and(63.31±11.13)%,respectively;PLT,PCT,PDW,MPV,and MAR in the severe stenosis group were(159.81±37.17)×10^(9)/L,(0.174±0.043)%,(17.98±0.36)%,(11.98±0.79)fl,and(75.89±16.98)%,respectively.The differences were statistically significant(P<0.05)when comparing PLT,PDW,MPV and MAR among the three groups.The differences were not statistically significant when comparing PCT in the three groups(P>0.05).PDW,MPV,and MAR in the severe stenosis group and moderate stenosis group were higher than those in the control group,and PLT was lower than that in the control group;PDW,MPV,and MAR in the severe stenosis group were higher than those in the moderate stenosis group,and PLT was lower than that in the moderate stenosis group;the differences were statistically significant (P<0.05). Conclusion The platelet parameters of patients with coronary heart disease are different from those of healthy people, which can be used as one of the important indicators to judge the severity of coronary artery lesions.