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Mean Platelet Volume and Peripheral Blood Count Response in Acute Ischemic Stroke

Yıl 2008, Cilt: 2008 Sayı: 2, 130 - 135, 01.02.2008

Öz

Objectives: Mean platelet volume (MPV) is a marker of the platelet activity and is reported to increase in vascular diseases. The aim of the study is to investigate the relationship between MPV and the subtypes of acute ischemic stroke. Patients and Methods: The patient group consisted of 102 acute ischemic stroke patients who were divided into the large vessel (n=43) and the small vessel (n=59) disease subgroups. Their MPV values were compared with those of 48 age/sex-matched healthy individuals. The relationship of MPV with the subtypes and severity of stroke, and other hematological parameters (platelet count, platecrit, hemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, leukocyte, neutrophil, lymphocyte, monocyte) was further investigated. Results: No difference was found in terms of MPV values between the patient subgroups and control group, and no relation was found between MPV and stroke severity and other hematological parameters (p>0.05). A significant increase in the leukocyte and neutrophil count was seen in patients of the large vessel disease group when compared with the small vessel disease and control group (p<0.005). Neutrophil count is found to be a risk factor for the stroke severity (β=0.362, p=0.01, OR=1.437, CI %95 0.02-0.08). Conclusion: No significant change in MPV was seen in acute ischemic stroke. High leukocyte and neutrophil levels are markers for the large vessel disease subtype and severity of ischemic stroke. Turkish Başlık: Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı Anahtar Kelimeler: İnme; ortalama trombosit hacmi; lökosit; nötrofil Amaç: Ortalama trombosit hacminin (OTH) trombosit aktivitesinin iyi bir göstergesi olduğu, vasküler hastalıklarda arttığı bildirilmektedir. Bu çalışmada akut iskemik inmede, inme alttipleri ile OTH'nin ilişkisinin araştırılması amaçlandı. Hastalar ve Yöntemler: Çalışmada ORG 10172 çalışması TOAST kriterlerine göre büyük (n=43) ve küçük (n=59) damar hastalığı olarak alttiplendirmesi yapılan, akut iskemik inme geçiren 102 hastanın OTH değerleri, yaş ve cinsiyet eşleştirilmiş 48 sağlıklı birey ile karşılaştırıldı. Ortalama trombosit hacminin inme alttipleri, inme şiddeti ve diğer hematolojik parametreler (trombosit sayısı, platekrit, hemoglobin, hematokrit, eritsosit sayısı, ortalama korpusküler hacim, lökosit, nötrofil, lenfosit, monosit sayıları) ile ilişkisi araştırıldı. Bulgular: İnme altgrupları ve kontrol grubu arasında OTH değerleri açısından fark tespit edilmezken, OTH ile inme şiddeti ve diğer hematolojik parametreler arasında da ilişki saptanmadı (p>0.05). Büyük damar hastalığı olanlarda, küçük damar hastalığı olanlara ve kontrollere göre lökosit ve nötrofil sayısında artışın anlamlı olarak daha fazla olduğu görüldü (p<0.005). Nötrofil sayısında artış inme şiddeti için bir risk faktörü olarak belirlendi (β=0.362, p=0.01, OR=1.437, CI %95 0.02-0.08). Sonuç: Ortalama trombosit hacmi akut iskemik inmede anlamlı bir değişikliğe uğramamakta olup, lökosit ve nötrofil sayısında artış, özellikle büyük damar hastalığı alttipi ve inme şiddeti için iyi bir göstergedir.

Kaynakça

  • Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-61.
  • Sharp DS, Benowitz NL, Bath PM, Martin JF, Beswick AD, Elwood PC. Cigarette smoking sensitizes and desensitizes impedance-measured ADP-induced platelet aggregation in whole blood. Thromb Haemost 1995;74:730-5.
  • Tschoepe D, Roesen P, Esser J, Schwippert B, Nieuwenhuis HK, Kehrel B, et al. Large platelets circulate in an activated state in diabetes mellitus. Semin Thromb Hemost 1991;17:433-8.
  • Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J 2008;49:114-6.
  • Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991;338:1409-11.
  • Crawford VL, McNerlan SE, Stout RW. Seasonal changes in platelets, fibrinogen and factor VII in elderly people. Age Ageing 2003;32:661-5.
  • Cameron HA, Phillips R, Ibbotson RM, Carson PH. Platelet size in myocardial infarction. Br Med J (Clin Res Ed) 1983;287:449-51.
  • Kario K, Matsuo T, Nakao K. Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haematol 1992;14:281-7.
  • Bath PM, Missouris CG, Buckenham T, MacGregor GA. Increased platelet volume and platelet mass in patients with atherosclerotic renal artery stenosis. Clin Sci (Lond) 1994;87:253-7.
  • O’Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995;26:995-9.
  • Butterworth RJ, Bath PM. The relationship between mean platelet volume, stroke subtype and clinical outcome. Platelets 1998;9:359-64.
  • Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35-41.
  • Fitzsimmons BF. Cerebrovascular disease: Ischemic stroke. In: Brust JCM, editor. Current diagnosis and treatment in neurology. 1st ed. New York: McGrawHill Medical; 2007. p. 100-25.
  • Shah AB, Beamer N, Coull BM. Enhanced in vivo platelet activation in subtypes of ischemic stroke. Stroke 1985;16:643-7.
  • Fisher M, Zipser R. Increased excretion of immunoreactive thromboxane B2 in cerebral ischemia. Stroke 1985;16:10-4.
  • Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke 1999;30:1538-41.
  • Tohgi H, Suzuki H, Tamura K, Kimura B. Platelet volume, aggregation, and adenosine triphosphate release in cerebral thrombosis. Stroke 1991;22:17-21.
  • Bath PM. The routine measurement of platelet size using sodium citrate alone as the anticoagulant. Thromb Haemost 1993;70:687-90.
  • Muscari A, Puddu GM, Cenni A, Silvestri MG, Giuzio R, Rosati M, et al. Mean platelet volume (MPV) increase during acute non-lacunar ischemic strokes. Thromb Res 2008 May 8. [Epub ahead of print]
  • Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke 2004;35:1688-91.
  • Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004;35:622-6.
  • Kazmierski R, Guzik P, Ambrosius W, Ciesielska A, Moskal J, Kozubski W. Predictive value of white blood cell count on admission for in-hospital mortality in acute stroke patients. Clin Neurol Neurosurg 2004;107:38-43.
  • Woo J, Lau E, Kay R, Lam CW, Cheung CK, Swaminathan R, et al. A case control study of some hematological and biochemical variables in acute stroke and their prognostic value. Neuroepidemiology 1990;9:315-20.
  • Rosell A, Cuadrado E, Ortega-Aznar A, HernándezGuillamon M, Lo EH, Montaner J. MMP-9-positive neutrophil infiltration is associated to blood-brain barrier breakdown and basal lamina type IV collagen degradation during hemorrhagic transformation after human ischemic stroke. Stroke 2008;39:1121-6.
  • Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke 2008;39:355-60.
  • Ross AM, Hurn P, Perrin N, Wood L, Carlini W, Potempa K. Evidence of the peripheral inflammatory response in patients with transient ischemic attack. J Stroke Cerebrovasc Dis 2007;16:203-7.
  • Fisher TC, Meiselmann HJ. Polymorphonuclear leukocytes in ischemic vascular disease. Thromb Res 1994;74 Suppl 1:S21-34.
  • Pantoni L, Sarti C, Inzitari D. Cytokines and cell adhesion molecules in cerebral ischemia: experimental bases and therapeutic perspectives. Arterioscler Thromb Vasc Biol 1998;18:503-13.
  • Akopov SE, Simonian NA, Grigorian GS. Dynamics of polymorphonuclear leukocyte accumulation in acute cerebral infarction and their correlation with brain tissue damage.Stroke 1996;27:1739-43.
  • Bednar MM, Raymond S, McAuliffe T, Lodge PA, Gross CE. The role of neutrophils and platelets in a rabbit model of thromboembolic stroke. Stroke 1991; 22:44-50.
  • Mori E, del Zoppo GJ, Chambers JD, Copeland BR, Arfors KE. Inhibition of polymorphonuclear leukocyte adherence suppresses no-reflow after focal cerebral ischemia in baboons. Stroke 1992;23:712-8.
  • del Zoppo GJ, Schmid-Schönbein GW, Mori E, Copeland BR, Chang CM. Polymorphonuclear leukocytes occlude capillaries following middle cerebral artery occlusion and reperfusion in baboons. Stroke 1991;22:1276-83.
  • Beray-Berthat V, Croci N, Plotkine M, Margaill I. Polymorphonuclear neutrophils contribute to infarction and oxidative stress in the cortex but not in the striatum after ischemia-reperfusion in rats. Brain Res 2003;987:32-8.
  • Beray-Berthat V, Palmier B, Plotkine M, Margaill I. Neutrophils do not contribute to infarction, oxidative stress, and NO synthase activity in severe brain ischemia. Exp Neurol 2003;182:446-54.

Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı

Yıl 2008, Cilt: 2008 Sayı: 2, 130 - 135, 01.02.2008

Öz

Amaç: Ortalama trombosit hacminin (OTH) trombosit
aktivitesinin iyi bir göstergesi olduğu, vasküler hastalıklarda
arttığı bildirilmektedir. Bu çalışmada akut iskemik
inmede, inme alttipleri ile OTH’nin ilişkisinin araştırılması
amaçlandı.
Hastalar ve Yöntemler: Çalışmada ORG 10172 çalışması TOAST kriterlerine göre büyük (n=43) ve küçük
(n=59) damar hastalığı olarak alttiplendirmesi yapılan,
akut iskemik inme geçiren 102 hastanın OTH değerleri,
yaş ve cinsiyet eşleştirilmiş 48 sağlıklı birey ile karşılaştırıldı. Ortalama trombosit hacminin inme alttipleri, inme
şiddeti ve diğer hematolojik parametreler (trombosit
sayısı, platekrit, hemoglobin, hematokrit, eritsosit sayısı,
ortalama korpusküler hacim, lökosit, nötrofil, lenfosit,
monosit sayıları) ile ilişkisi araştırıldı.
Bulgular: İnme altgrupları ve kontrol grubu arasında
OTH değerleri açısından fark tespit edilmezken, OTH
ile inme şiddeti ve diğer hematolojik parametreler
arasında da ilişki saptanmadı (p > 0.05). Büyük damar
hastalığı olanlarda, küçük damar hastalığı olanlara
ve kontrollere göre lökosit ve nötrofil sayısında artışın
anlamlı olarak daha fazla olduğu görüldü (p < 0.005).
Nötrofil sayısında artış inme şiddeti için bir risk faktörü
olarak belirlendi (β=0.362, p=0.01, OR=1.437, CI %95
0.02-0.08).
Sonuç: Ortalama trombosit hacmi akut iskemik inmede
anlamlı bir değişikliğe uğramamakta olup, lökosit ve
nötrofil sayısında artış, özellikle büyük damar hastalığı
alttipi ve inme şiddeti için iyi bir göstergedir.

Kaynakça

  • Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-61.
  • Sharp DS, Benowitz NL, Bath PM, Martin JF, Beswick AD, Elwood PC. Cigarette smoking sensitizes and desensitizes impedance-measured ADP-induced platelet aggregation in whole blood. Thromb Haemost 1995;74:730-5.
  • Tschoepe D, Roesen P, Esser J, Schwippert B, Nieuwenhuis HK, Kehrel B, et al. Large platelets circulate in an activated state in diabetes mellitus. Semin Thromb Hemost 1991;17:433-8.
  • Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J 2008;49:114-6.
  • Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991;338:1409-11.
  • Crawford VL, McNerlan SE, Stout RW. Seasonal changes in platelets, fibrinogen and factor VII in elderly people. Age Ageing 2003;32:661-5.
  • Cameron HA, Phillips R, Ibbotson RM, Carson PH. Platelet size in myocardial infarction. Br Med J (Clin Res Ed) 1983;287:449-51.
  • Kario K, Matsuo T, Nakao K. Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haematol 1992;14:281-7.
  • Bath PM, Missouris CG, Buckenham T, MacGregor GA. Increased platelet volume and platelet mass in patients with atherosclerotic renal artery stenosis. Clin Sci (Lond) 1994;87:253-7.
  • O’Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995;26:995-9.
  • Butterworth RJ, Bath PM. The relationship between mean platelet volume, stroke subtype and clinical outcome. Platelets 1998;9:359-64.
  • Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35-41.
  • Fitzsimmons BF. Cerebrovascular disease: Ischemic stroke. In: Brust JCM, editor. Current diagnosis and treatment in neurology. 1st ed. New York: McGrawHill Medical; 2007. p. 100-25.
  • Shah AB, Beamer N, Coull BM. Enhanced in vivo platelet activation in subtypes of ischemic stroke. Stroke 1985;16:643-7.
  • Fisher M, Zipser R. Increased excretion of immunoreactive thromboxane B2 in cerebral ischemia. Stroke 1985;16:10-4.
  • Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke 1999;30:1538-41.
  • Tohgi H, Suzuki H, Tamura K, Kimura B. Platelet volume, aggregation, and adenosine triphosphate release in cerebral thrombosis. Stroke 1991;22:17-21.
  • Bath PM. The routine measurement of platelet size using sodium citrate alone as the anticoagulant. Thromb Haemost 1993;70:687-90.
  • Muscari A, Puddu GM, Cenni A, Silvestri MG, Giuzio R, Rosati M, et al. Mean platelet volume (MPV) increase during acute non-lacunar ischemic strokes. Thromb Res 2008 May 8. [Epub ahead of print]
  • Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke 2004;35:1688-91.
  • Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004;35:622-6.
  • Kazmierski R, Guzik P, Ambrosius W, Ciesielska A, Moskal J, Kozubski W. Predictive value of white blood cell count on admission for in-hospital mortality in acute stroke patients. Clin Neurol Neurosurg 2004;107:38-43.
  • Woo J, Lau E, Kay R, Lam CW, Cheung CK, Swaminathan R, et al. A case control study of some hematological and biochemical variables in acute stroke and their prognostic value. Neuroepidemiology 1990;9:315-20.
  • Rosell A, Cuadrado E, Ortega-Aznar A, HernándezGuillamon M, Lo EH, Montaner J. MMP-9-positive neutrophil infiltration is associated to blood-brain barrier breakdown and basal lamina type IV collagen degradation during hemorrhagic transformation after human ischemic stroke. Stroke 2008;39:1121-6.
  • Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke 2008;39:355-60.
  • Ross AM, Hurn P, Perrin N, Wood L, Carlini W, Potempa K. Evidence of the peripheral inflammatory response in patients with transient ischemic attack. J Stroke Cerebrovasc Dis 2007;16:203-7.
  • Fisher TC, Meiselmann HJ. Polymorphonuclear leukocytes in ischemic vascular disease. Thromb Res 1994;74 Suppl 1:S21-34.
  • Pantoni L, Sarti C, Inzitari D. Cytokines and cell adhesion molecules in cerebral ischemia: experimental bases and therapeutic perspectives. Arterioscler Thromb Vasc Biol 1998;18:503-13.
  • Akopov SE, Simonian NA, Grigorian GS. Dynamics of polymorphonuclear leukocyte accumulation in acute cerebral infarction and their correlation with brain tissue damage.Stroke 1996;27:1739-43.
  • Bednar MM, Raymond S, McAuliffe T, Lodge PA, Gross CE. The role of neutrophils and platelets in a rabbit model of thromboembolic stroke. Stroke 1991; 22:44-50.
  • Mori E, del Zoppo GJ, Chambers JD, Copeland BR, Arfors KE. Inhibition of polymorphonuclear leukocyte adherence suppresses no-reflow after focal cerebral ischemia in baboons. Stroke 1992;23:712-8.
  • del Zoppo GJ, Schmid-Schönbein GW, Mori E, Copeland BR, Chang CM. Polymorphonuclear leukocytes occlude capillaries following middle cerebral artery occlusion and reperfusion in baboons. Stroke 1991;22:1276-83.
  • Beray-Berthat V, Croci N, Plotkine M, Margaill I. Polymorphonuclear neutrophils contribute to infarction and oxidative stress in the cortex but not in the striatum after ischemia-reperfusion in rats. Brain Res 2003;987:32-8.
  • Beray-Berthat V, Palmier B, Plotkine M, Margaill I. Neutrophils do not contribute to infarction, oxidative stress, and NO synthase activity in severe brain ischemia. Exp Neurol 2003;182:446-54.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Babürhan Güldiken Bu kişi benim

Hülya Özkan Bu kişi benim

Levent Kabayel Bu kişi benim

Yayımlanma Tarihi 1 Şubat 2008
Yayımlandığı Sayı Yıl 2008 Cilt: 2008 Sayı: 2

Kaynak Göster

APA Güldiken, B., Özkan, H., & Kabayel, L. (2008). Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı. Balkan Medical Journal, 2008(2), 130-135.
AMA Güldiken B, Özkan H, Kabayel L. Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı. Balkan Medical Journal. Şubat 2008;2008(2):130-135.
Chicago Güldiken, Babürhan, Hülya Özkan, ve Levent Kabayel. “Akut İskemik İnmede Ortalama Trombosit Hacmi Ve Periferik Kan Hücre Sayısı Yanıtı”. Balkan Medical Journal 2008, sy. 2 (Şubat 2008): 130-35.
EndNote Güldiken B, Özkan H, Kabayel L (01 Şubat 2008) Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı. Balkan Medical Journal 2008 2 130–135.
IEEE B. Güldiken, H. Özkan, ve L. Kabayel, “Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı”, Balkan Medical Journal, c. 2008, sy. 2, ss. 130–135, 2008.
ISNAD Güldiken, Babürhan vd. “Akut İskemik İnmede Ortalama Trombosit Hacmi Ve Periferik Kan Hücre Sayısı Yanıtı”. Balkan Medical Journal 2008/2 (Şubat 2008), 130-135.
JAMA Güldiken B, Özkan H, Kabayel L. Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı. Balkan Medical Journal. 2008;2008:130–135.
MLA Güldiken, Babürhan vd. “Akut İskemik İnmede Ortalama Trombosit Hacmi Ve Periferik Kan Hücre Sayısı Yanıtı”. Balkan Medical Journal, c. 2008, sy. 2, 2008, ss. 130-5.
Vancouver Güldiken B, Özkan H, Kabayel L. Akut İskemik İnmede Ortalama Trombosit Hacmi ve Periferik Kan Hücre Sayısı Yanıtı. Balkan Medical Journal. 2008;2008(2):130-5.