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1、脑梗死患者血小板参数的测定及临床意义作者：简崇东，毕桂南，石胜良，谢姚屹【摘要】目的检测脑梗死患者外周血的血小板参数，研究脑梗死发病后不同时间段及不同梗死面积的血小板参数变化，为临床应用抗血小板聚集治疗脑梗死提供理论依据。方法应用全自动血细胞分析仪,对97例脑梗死患者及40例健康体检者进行血小板参数(主要指血小板计数、血小板平均体积、血小板分布宽度)检测,按不同发病时间段分为<48h内组(20例)、49h〜7d组(33例)、7〜14d天组(11例),14d后组(33例)；按梗死面积不同分为腔隙性脑梗死组(39例)、小面
2、积梗死组(29例)、大面积梗死组(29例)。对各组与对照组间及各组之间的血小板参数进行比较。结果脑梗死患者急性期外周血血小板计数(Pit)降低，血小板平均体积(MPV)、血小板分布宽度(PDW)升高。发病48h内卩吐显著减少(P<0.01),7〜14d及>14d逐渐恢复正常(P>0.05);发病48h内MPV及PDW显著升高(P<0.01),49h~7d达高峰，之后逐渐降低，但至14d后仍高于正常水平(P<0.05)。脑梗死面积越大，患者Plt越低(P<0.05),MPV、PDW越高(P&
3、lt;0.05)。结论在动脉粥样硬化及脑梗死患者中动态监测血小板参数的变化，有助于脑梗死的预防及预后的判断。【关键词】脑梗死；血小板计数；血小板平均体积；血小板分布宽度AbstractObjectiveTostudytheregularityandsignificanceofthevariationsoftheplateletparametersincerebralinfarction(CI)duringdifferentperiodandinfarctsizeandprovidetheoreticalbasistheant
4、iplateletaggregationtreatment・Methods97caseswithcerebralinfarctionand40healthyparticipdntsweredetectedtheplateletparanietersbyautomatichematologyanalyzer・Theyweredividedintofourgroupsbydifferentperiods(<48hours,49h〜7days,7〜lddaysand>lddays)anddividedintothree
5、groupsbytheinfarctsize(1argesizesmal1sizeandlacunarCT)・ThestudyselectestheCTpatients(Cigroup)andthehealthyphysicalexaminees(controlgroup)inthesamehospitaiandduringthesameinterva1・Withregardtoplateletstudygroup:Intermsoftimeofincidence(in48h,49h〜7d,7〜14dandafterl4d)
6、andinfarctsize(largesizesmallsizeandlacunarCI)・WeseparatetheCTgroupintodifferentsubgroups,eachsubgroupwerecomparedwithcontrolseparately,andalsomakegroupcomparisonbetweenplateletgroup・ResultsThePLTisthelowestin48hafterCTonset,butascendgraduallywiththetimedeveloped,a
7、ndrecoveredtonormal1eve1atthelddayspostcurrently(卩&It;0.05)・Comparingwithcontrolgroup,MPVandPDWascendmarkedlyin48hafterCTonset(P<0.05)andreachthepeaksatthetimeof48h〜7d,thendescendgradual1y,butevenhigherthancontrolgroupattherecoveryperiod(P<0.05).Thelargerthei
8、nfarctsizeis,thelowerthePLTis,andthehighertheMPV、PDWare・ConelusionDetectingtheplateletparametersofpatientswithCIandatherosclerosisisvaluableforth
