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Thromb Haemostasis:血小板周转可以预测冠状动脉介入治疗后患者预后?

2017-05-31 xing.T MedSci原创

总之,RPF作为血小板周转率的指标是PCI术后接受双抗治疗患者发生MACE和出血事件的独立预测因素。由于RPF可以可靠地量化以及连同常规血象,RPF可能很容易被应用于预测心血管风险。

升高的血小板周转率导致血小板高反应性。经皮冠状动脉介入治疗(PCI)后血小板高反应性与主要心血管不良事件(MACE)相关。近日,血栓和凝血疾病权威杂志Thrombosis and Haemostasis上发表了一篇研究文章,研究人员旨在明确PCI支架置入术后血小板周转率和功能对MACE的预测价值。

在这项前瞻性观察性研究中,486例连续就诊的进行PCI术且服用阿司匹林和氯吡格雷的患者被纳入研究,并且测定了血小板的周转率(平均血小板体积(MPV)、网织血小板分数(RPF))和血小板功能(多电极法(MEA)、血管舒张剂刺激磷蛋白磷酸化(VASP-P)法)。

在六个月的随访,10.7 %的病人发生MACE。RPF(比值比[OR]为1.173(95%可信区间[CI] 为1.040-1.324),P=0.009)和MPV(OR值为1.459(95%CI为1.059-2.008),P=0.021)是MACE的单变量预测因子,而VASP-P(OR为1.016(95%CI为1-1.032),P=0.052)和MEA(OR为0.999(95%CI为0.980-1.017),P=0.895)未能预测MACE的发生。RPF仍然是与MACE独立相关的唯一血小板指标。

最好的预测MACE的模型纳入了肌钙蛋白I(OR为1.007(95 %CI为1.002-1.012),P=0.009)、RPF(OR为1.136(95%CI为1.001-1.288),P=0.048)、CRP(OR为1.008(95%CI为1.001-1.014),P=0.023)和心肌梗死病史(OR为2.039(95%CI为1.093-3.806),P=0.025)。RPF(OR为1.211(95%CI为1.042-1.406),P=0.012)也与院内出血存在独立相关性。

总之,RPF作为血小板周转率的指标是PCI术后接受双抗治疗患者发生MACE和出血事件的独立预测因素。由于RPF可以可靠地量化以及连同常规血象,RPF可能很容易被应用于预测心血管风险。

原始出处:

M. K. Freynhofer,et al. Platelet turnover predicts outcome after coronary intervention.Thrombosis and Haemostasis.2017. https://th.schattauer.de/en/contents/archive/issue/2480/issue/special/manuscript/27239/show.html

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    2018-03-12 changfy
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1691901, encodeId=0dd91691901a5, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Tue Dec 19 08:51:00 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008256, encodeId=54af2008256d4, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Mon Mar 12 19:51:00 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648928, encodeId=f4b3164892878, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Sat Feb 03 15:51:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1794290, encodeId=c00c1e9429007, content=<a href='/topic/show?id=fb7d16e489b' target=_blank style='color:#2F92EE;'>#STAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16748, encryptionId=fb7d16e489b, topicName=STAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=af60254, createdName=mhm289, createdTime=Wed Jan 17 07:51:00 CST 2018, time=2018-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204995, encodeId=9fdf204995d1, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu Jun 01 00:35:16 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204895, encodeId=a365204895ab, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed May 31 19:58:47 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204873, encodeId=875c2048e35f, content=666沉迷于学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed May 31 18:40:43 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204867, encodeId=afe720486ee7, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Wed May 31 18:18:23 CST 2017, time=2017-05-31, status=1, ipAttribution=)]
    2018-01-17 mhm289
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    2017-06-01 tanxingdoctor

    学习啦谢谢分享

    0

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    2017-05-31 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2017-05-31 虈亣靌

    666沉迷于学习

    0

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    2017-05-31 tanxingdoctor

    学习啦谢谢分享

    0

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