无症状冠心病颈动脉内膜中层厚度与血小板相关指标和超敏C反应蛋白的相关性

摘要

目的：探讨无症状冠心病人群使用彩色多普勒超声评估颈动脉内膜中层厚度（ carotid intima-media thickness， IMT）与血小板平均体积（ mean platelet volume，MPV）、血小板体积分布宽度（ platelet volume distribution width，PDW）和超敏C反应蛋白（ hypersensitive c-reactive protein，Hs-CRP）之间的相关性。方法选取符合无症状冠心病诊断标准的患者85例做为研究对象。根据颈动脉IMT结果分为正常组（ n＝30例）和增厚组（ n＝55例），比较两组之间TG、UA、MPV、PDW、Hs-CRP的差别，然后再采用多元线性回归分析颈动脉IMT的相关因素。结果 IMT增厚组TG、UA、MPV、PDW、Hs-CRP水平明显高于正常组，两组之间的差异有统计学意义（均P＜0．05），多元线性回归分析表明颈动脉IMT与MPV（β＝0．215，P＜0．001）， PDW（β＝－0．039，P＝0．037），Hs-CRP（β＝0．258，P＝0．001）相关。结论 MPV、PDW、Hs-CRP与无症状颈动脉粥样硬化呈独立相关，MPV升高可能是动脉粥样硬化初始阶段关键的生物学标记物。%Objective To study the relationship between carotid intima-media thickness ( IMT) and mean platelet volume ( MPV) , platelet volume distribution width ( PDW) and hypersensitive c-reactive protein ( Hs-CRP) without clinical manifestation of atherosclerotic cardiovascular disease.Methods Retrospective analysis was performed.We studied the individuals who underwent the color Doppler ultrasound from February to November in 2014.The patients who had known atherosclerotic disease were excluded from study and 85 cases were finally admitted for the study.The patients were divided into IMT high group (55 cases) and IMT normal group (30 cases) according to the median carotid IMT values.A multiple linear regression analysis was performed to identify the inde-pendent associations of carotid IMT.Results The IMT high group had higher triglycerides ( TG) , uric acid ( UA) , MPV, PDW and Hs-CRP levels than those of the IMT normal group (P<0.05 for all).Multiple linear regression analysis showed that carotid IMT was independently related with MPV (β=0.215, P<0.001), PDW(β=-0.039, P=0.037)and Hs-CRP (β=0.258, P=0.001). Conclusions MPV、PDW or Hs-CRP is independently related to the extent of subclinical carotid atherosclerosis respectively.Increase in MPV may be a crucial biochemical marker for initial atherosclerosis.