The Role of Circulating Platelets Microparticles and Platelet Parameters in Acute Ischemic Stroke Patients.
The Role of Circulating Platelets Microparticles and Platelet Parameters in Acute Ischemic Stroke Patients.
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DOI：
10.1016/j.jstrokecerebrovasdis.2015.06.018
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Chen Y
中科院分区：
文献类型：
--
作者：
Chen Y;Xiao Y;Lin Z;Xiao X;He C;Bihl JC;Zhao B;Ma X;Chen Y
血小板活化和聚集在急性缺血性卒中（AIS）的发病机制中至关重要。循环血小板微粒（PMPs）和血小板参数是AIS患者血小板功能的生物学标志物，然而，它们与卒中亚型和梗死体积的相关性仍然未知。我们招募了112名AIS患者，包括大动脉粥样硬化（LAA）和小动脉闭塞（SAO）亚型，并在这项研究中招募了35名对照。在入院时和抗血小板治疗后采集血样。采用流式细胞术和血液学分析分别测定循环PMPs水平和血小板参数[平均血小板体积（MPV）、血小板计数（PC）、血小板压积（PCT）和血小板分布宽度（PDW）]。入院时通过磁共振成像检查脑CT容积。(1)AIS患者循环PMPs和MPV水平较健康对照组显著升高;（2）AIS患者抗血小板治疗后循环PMPs水平降低，但血小板参数无明显变化;（3）LAA亚型梗死体积大于SAO亚型。值得注意的是，循环PMP水平与LAA亚型的梗死体积呈正相关。两种AIS亚型的血小板参数与梗死体积均无相关性;（4）回归分析显示，在调整其他影响因素（高血压和糖尿病）后，循环中的PMPs是合并AIS患者梗死体积的独立危险因素。本研究结果提示循环PMP水平与AIS患者脑损伤有关，为AIS患者的脑损伤提供了一个新的评价指标。
Platelet activation and aggregation are critical in the pathogenesis of acute ischemic stroke (AIS). Circulating platelet microparticles (PMPs) and platelet parameters are biological markers of platelet function in AIS patients, however, their associations with stroke subtypes and infarct volume remain unknown. We recruited 112 AIS patients including large artery atherosclerosis (LAA) and small artery occlusion (SAO) subtypes, and 35 controls in this study. Blood samples were collected at admission and after antiplatelet therapy. The levels of circulating PMPs and platelet parameters [mean platelet volume (MPV), platelet count (PC), plateletocrit (PCT) and platelet distribution width (PDW)] were determined by flow cytometry and hematology analysis, respectively. Infarct volume was examined at admission by magnetic resonance imaging. (1) The levels of circulating PMPs and MPV were significantly elevated in AIS patients when compared with healthy controls; (2) The level of circulating PMPs, but not platelet parameters, was decreased after antiplatelet therapy in AIS patients; (3) The infarct volume in LAA subtype was larger than that in SAO subtype. Notably, circulating PMP level was positively correlated with the infarct volume in LAA subtype. No association with infarct volume in either AIS subtype was observed for platelet parameters; (4) According to the regression analysis, circulating PMPs was an independent risk factor for the infarct volume in pooled AIS patients after adjustments of other impact factors (hypertension and diabetes). Our results suggest that circulating PMP level is associated with cerebral injury of AIS, which offers a novel evaluation parameter for AIS patients.