非血液学疾病患者血小板参数分析

Priyanka Pappula, Vallamreddy Siva Kota Reddy, Vaheda Begam Korrapadu, Hima Bindu Gurram
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摘要

背景与目的:糖尿病患者血小板反应性增高。胰岛素抵抗和胰岛素缺乏都会增加血小板反应性。血小板在急性冠脉综合征(ACS)的发病机制中起着至关重要的作用。研究表明,PC和MPV是原发性脑出血预后不良的独立预测因子。本研究旨在分析2型糖尿病、急性冠状动脉综合征、急性缺血性脑卒中等非血液学疾病患者的血小板参数。材料与方法:收集400名受试者的血液样本,使用Sysmex KX-21全自动血液分析仪进行分析。对300例非血液病患者和100例年龄和性别匹配的健康对照者进行了血小板指数如PC、MPV、PDW和P-LCR的检测。为了考虑血小板的排列、粒度和大小,对外周血涂片上的血小板形态进行了研究。结果:非血液学疾病中,2型糖尿病占37.33% (n=112), ACS占35.67% (n=107), AIS占27% (n=81)。2型糖尿病患者与健康对照组相比,PC随MPV升高有统计学意义。急性冠脉综合征患者MPV和PDW明显升高。在急性缺血性卒中中,我们注意到与对照组相比,MPV升高,PC降低。研究显示,90%的2型糖尿病患者、88%的ACS患者和80%的AIS患者存在血小板离散排列。不同临床条件下的PBS显示84%的2型糖尿病患者、81%的ACS患者和83%的AIS患者的血小板粒度。研究显示,2型糖尿病患者中有60%、ACS患者中有56%、AIS患者中有52%的大血小板增加。在2型糖尿病、ACS和AIS病例中,PBS上大血小板的百分比超过正常范围,表明血小板大小的增加支持MPV的增加。结论:血小板指标的测定可为急诊医师诊治ACS和AIS患者提供有用的诊断和预后信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of platelet parameters in patients with non-hematological disorders
Background & Aims : People with diabetes, exhibit increased platelet reactivity. Both insulin resistance and insulin deficiency increase platelet reactivity. Platelets play a vital role in the pathogenesis of acute coronary syndromes (ACS). It has been shown that PC and MPV are independent predictors for poor outcome in primary intracerebral hemorrhage. The aim of the study is to analyze the platelet parameters in patients with some non-hematological disorders such as diabetes mellitus type 2, acute coronary syndrome, and acute ischemic stroke. Materials & Methods : Blood samples were collected from 400 subjects and analysed using the Sysmex KX-21 automated hematology analyser. 300 patients presenting with non-hematological disorders and 100 age and sex matched healthy controls were checked for Platelet indices such as PC, MPV, PDW and P-LCR. The platelet morphology was studied on peripheral blood smear for considering the arrangement, granularity and size of platelets. Results : In total non-hematological disorders, DM type 2 accounts 37.33% (n=112), followed by 35.67% of ACS (n=107), and 27% of AIS (n=81). In diabetes mellitus type 2, PC was statistically elevated along with MPV compared with healthy controls. MPV and PDW were significantly raised in the patients admitted with ACS. In acute ischemic stroke, we noted that there was an elevation in MPV and a decrease in PC compared to them in the control group. Study showed discrete arrangement of platelets in 90% of DM type 2, 88% of ACS, and 80% of AIS patients. PBS in various clinical conditions showed granularity of platelets in 84 % of DM type 2, 81% of ACS and 83% of AIS patients. Study showed increased percentage of macrothrombocytes as 60% of DM type 2, 56% of ACS and 52% of AIS patients. The percentage of large platelets on PBS was increased beyond normal limits in DM type 2, ACS and AIS cases, indicating that there is an increase in size of the platelets supporting an increase in MPV. Conclusion : The measurement of platelet indices may provide useful diagnostic and prognostic information to emergency physicians caring for patients with ACS and AIS.
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