血小板體積參數於高血脂成人的評估以及與血脂比值的相關性

Evaluation of Platelet Volume Indices in Adults with Hyperlipidemia and Correlation with Lipid Ratio

目的： 血小板體積參數包括平均血小板體積、血小板分佈寬度與大型血小板比例。大血小 板在代謝上與酶催化上比起小血小板更易具有活性與產生較多的血栓因子。而低密度 脂蛋白/ 高密度脂蛋白比值已證明比起單獨使用低密度或高密度脂蛋白來預測冠心症風 險是更有力的預測因子。本研究調查高血脂成人的血小板體積參數及其與低密度脂蛋 白/ 高密度脂蛋白比值之間的相關性。 方法： 本研究收納18 歲以上，於2015 年1 月9 日至3 月31 日期間曾到台灣中部某教學 醫院門診看診，並同時檢驗血脂與血小板數的民眾，依2003 年國民健康署與中華民國 血脂與動脈硬化學會制定之「中華民國血脂異常分類之建議」而被區分為高血脂與非 高血脂成人。最終納入85 位受試者，高血脂組有35 位，而非高血脂組有50 位。 結果： 在高血脂組血小板參數的平均值：平均血小板體積為9.94±0.71；血小板分佈寬度為 10.99±1.48；大型血小板比例為24.29±5.65，皆明顯高於控制組（平均血小板體積8.97 ± 0.42；血小板分佈寬度為9.19 ± 0.83；大型血小板比例16.39 ± 3.24, p<0.05）。而平均血 小板體積（r=0.285, p=0.008）；血小板分佈寬度（r=0.396, p=0.001）；與大型血小板比 例（r=0.269, p=0.013）皆顯示與LDL/HD 為顯著正相關。 結論： 高血脂相較於非高血脂組成人明顯有較高數值的平均血小板體積、血小板分佈寬度 與大型血小板比例，而且這些血小板參數與低密度脂蛋白/ 高密度脂蛋白比值之間也呈 顯著相關性。高血脂成人的血小板因為有較高數值的血小板參數而可能顯得較為凝集 與活化。高血脂成人罹患粥樣動脈硬化所增加的的風險可能就是高數值血小板體積參 數的結果。這些血小板參數也許能作為高血脂族群冠心症風險的一個早期、經濟與快 速的識別標記。

Purposes: Platelet volume indices (PVIs) includes the mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Larger platelets tend to be metabolically and enzymatically more active compared to smaller platelets and secrete more prothrombotic factors. The low-density lipoprotein (LDL)/ high-density lipoprotein (HDL) ratio is a more powerful coronary risk predictor than either LDL or HDL alone. This study invesgated PVIs in adults with hyperlipidemia and the correlation between PVIs and the LDL/HDL ratio. Methods: The study enrolled adults aged ≥18 years who visited the outpatient division of a regional teaching hospital in central Taiwan from January 9 to March 31, 2015. Subjects were tested for serum lipids and platelet counts and were divided into hyperlipidemic and normolipidemic group according to the Dyslipidemia Classifications suggested by the Health Promotion Administration and Taiwan Society of Lipids & Atherosclerosis in 2003. Of the 85 adults eventually included, 35 were in the hyperlipidemic group and 50 in the normolipidemic group. Results: The mean values for MPV (9.94±0.71), PDW (10.99±1.48) and P-LCR (24.29±5.65) in the study group were significantly higher compared to those in the control group (MPV = 8.97 ± 0.42, PDW= 9.19 ±0.83, P-LCR= 16.39 ± 3.24; p< 0.05). MPV (r=0.285, p=0.008), PDW (r=0.396, p=0.001) and P-LCR (r=0.269, p=0.013) all showed significant positive correlations with LDL/HDL. Conclusions: Adults with hyperlipidemia had significantly higher MPV, PDW, and P-LCR values compared to normolipidemic adults. There was a significant correlation between the LDL/HDL ratio and PVIs. Platelets of adults with hyperlipidemia may become more aggregable and reactive owing to increased PVIs. The increased risk of atherosclerosis in adults with hyperlipidemia may be a result of high PVIs. These indices may be used for early, cost-effective and rapid identification of coronary risk factors in adults with hyperlipidemia.