【作者】 汪亮；

【导师】 张霞；

【作者基本信息】 重庆医科大学 ， 内科学， 2010， 硕士

【摘要】 目的:血小板平均体积(mean platelet volume, MPV)是评价血小板活性的一种指标。血小板活化、聚集是冠心病(coronary heart disease, CHD)发病机制的中心环节。非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)在普通人群中的发病率高达1/3,并且是心脏代谢性疾病的主要危险因素,常常合并有腹型肥胖、2型糖尿病(T2DM)及其它代谢综合征(metabolic syndrome, MS)亚组分。本研究的目的就是初步阐明NAFLD患者MVP的变化规律。方法:检测50例正常人和例NAFLD患者的MPV水平,并进行统计学分析。结果:①NAFLD组与正常对照组相比PC减少而MPV升高(10.43±1.14 vs. 9.09±1.25; p < 0.001)。②MPV与谷草转氨酶(AST) (r=0.186, p < 0.042)、谷丙转氨酶(ALT)(r=0.279; p=0.002)及NAFLD(r=0.492; p < 0.001)正相关;而与血小板计数(PC)(r=?0.26; p=0.004)、肌酐(Cr)(r=?0.255; p=0.005)负相关。③以MPV为应变量,性别、年龄、收缩压(SBP)、舒张压(DBP)、NAFLD、MPV、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、PC、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、Cr、AST、ALT为自变量,进行逻辑回归分析,结果表明NAFLD是MPV的独立预测指标(Odds Ratio (OR) 21.98) [95% confidence interval (CI): 2.404–201.048; p= 0.006]。结论:NAFLD患者有较大的MPV值,并可在一定程度上预测心血管疾病(cardiovascular disease, CVD)的发生。更多还原

【Abstract】 Objective: Mean platelet volume (MPV) is an indictor of platelet activation. Platelet activation and aggregation are central processes in the pathophysiology of coronary heart disease(CHD). Non-alcoholic fatty liver disease (NAFLD) is present up to one–third of the general population and the majority of patients with cardio-metabolic risk factors such as abdominal obesity, type 2 diabetes and other components of the metabolic syndrome (MS). The aim of the current study was to investigate the MPV in patients who had NAFLD.Methods: The level of MPV was measured in 50 normal controls and 65 patients with NAFLD. A statistically analysis of the data was conducted.Results:①MPV values of the patients with NAFLD and of the patients without fatty liver disease were compared.Among biochemical variables, fasting plasma glucose and triglyceride were significantly higher in the NAFLD group. NAFLD cases also had lower platelet count and higher MPV (10.43±1.14 vs. 9.09±1.25; p < 0.001, respectively). ②MPV was positively correlated with AST (r=0.186, p < 0.042), ALT level (r=0.279; p= 0.002) and the presence of NAFLD (r=0.492; p < 0.001) but negatively correlated with platelet number (r=?0.26; p=0.004) and creatinine (r=?0.255; p=0.005).③In logistic regression analysis [age, gender, NAFLD, high-density lipid cholesterol (HDL-C), systolic and diastolic blood pressure (SBP, DBP), triglyceride (TG) and fasting plasma glucose (FPG) were used as covariates] only NAFLD was found to be the independent predictor of MPV (Odds Ratio (OR) 21.98) [95% confidence interval (CI): 2.404–201.048; p= 0.006].Conclusions: Patients with NAFLD have higher MPV. It may,to some extence, have prognostic value in NAFLD patients indicating a possible cardiovascular disease (CVD).更多还原