Relationship between the extent of dissection and platelet activation in acute aortic dissection.
Relationship between the extent of dissection and platelet activation in acute aortic dissection.
复制标题
急性主动脉夹层夹层范围与血小板活化的关系。
DOI：
10.1186/s13019-015-0351-5
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发表时间：
2015-11-10
影响因子：
1.6
通讯作者：
Meng W
中科院分区：
文献类型：
--
作者：
Zhang S;Qian H;Yang Q;Hu J;Gan C;Meng W
急性主动脉夹层（AAD）的范围与炎症呈正相关。另一方面，炎症与平均血小板体积（MPV）呈负相关，这可以反映血小板（PLT）的活化。本研究的目的是阐明夹层程度与血小板活化之间的关系。2010年2月至2013年10月期间，147例急性主动脉夹层（AAD）患者被分为第1组（斯坦福大学A组，n = 59）和第2组（斯坦福大学B组，n = 88）。测定血小板计数、MPV和血小板大小分布宽度（PDW）以评估PLT活化。此外，通过血清C-反应蛋白（CRP）、白色血细胞（WBC）计数和中性粒细胞百分比（Neut%）评估炎症的严重程度。采用CT检查分析AAD的范围。体积撕裂指数（VTI）计算为假腔（FL）体积除以体表面积（BSA）。血小板计数（137.24 ± 31.04 × 109/L）明显低于对照组（171.43 ± 27.57 × 109/L，P < 0.001）。第1组MPV/PLT比值和PDW明显高于第2组（0.08 ± 0.02vs0.06 ± 0.02，P < 0.001; 22.65 ± 1.87fl vs20.69 ± 1.97fl，P < 0.001）。第1组CRP明显高于第2组（36.40 ± 8.89 mg/L vs 28.97 ± 8.48 mg/L，P < 0.001）。VTI值1组明显高于2组（250.12 ± 27.82vs198.79 ± 24.52，P < 0.001）。VTI与PLT计数呈显著负相关（r =-0.673，P < 0.001）; CRP与PLT计数呈显著负相关（r =-0.640，P < 0.001）。VTI与CRP（r = 0.670，P < 0.001）、PDW（r = 0.601，P < 0.001）呈显著正相关。AAD患者的血小板活化和炎症反应与主动脉夹层的程度密切相关，可能是主动脉壁撕裂所致。消除假腔是传统外科手术的目标。抑制血小板活化可能是预防AAD患者全身炎症的未来治疗目标。
The extent of acute aortic dissection (AAD) was correlated with inflammation positively. On the other side, inflammation was negatively correlated with mean platelet volume (MPV), which can reflect platelet (PLT) activation. The aim of this study was to clarify the relationship between the extent of dissection and PLT activation. Between February 2010 and October 2013, 147 patients with acute aortic dissection (AAD) were divided into Group 1 (Stanford A, n = 59) and Group 2 (Stanford B, n = 88). Platelet count, MPV and platelet size distribution width (PDW) were measured to assess PLT activation. Additionally, the severity of inflammation was assessed via serum C-reactive protein (CRP), white blood cell (WBC) count and the neutrophil percent (Neut%). Computerized tomography (CT) was employed to analyze the extent of AAD. Volume tear index (VTI) was calculated as the false lumen (FL) volume divided by body surface area (BSA). PLT count was significantly lower in group 1 than in group 2 (137.24 ± 31.04 × 109/L vs 171.43 ± 27.57 × 109/L, P < 0.001). The MPV/PLT ratio and PDW were significantly higher in the group 1 respectively(0.08 ± 0.02 vs 0.06 ± 0.02, P < 0.001; 22.65 ± 1.87 fl vs 20.69 ± 1.97 fl, P < 0.001). The CRP was significantly higher in group 1 than in group 2 (36.40 ± 8.89 mg/L vs 28.97 ± 8.48 mg/L, P < 0.001). VTI was significantly higher in group 1 than in group 2 (250.12 ± 27.82 vs 198.79 ± 24.52, P < 0.001). There was a significant negative correlation between VTI and PLT count (r = −0.673, P < 0.001), CRP and PLT count (r = −0.640, P < 0.001), respectively. There was a significant positive correlation between VTI and CRP (r = 0.670, P < 0.001), VTI and PDW (r = 0.601, P < 0.001), respectively. PLT activation and inflammation in AAD appear to be closely correlated with the extent of dissection, which possibly induced by the tear of aortic wall. Elimination of the false lumen is the goal of traditional surgery. Suppression of the PLT activation might be future targets of therapy in the prevention of systemic inflammation in AAD patients.