平均血小板体积对血液透析患者急性缺血性脑血管病事件的预测价值

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Abstract Objective To investigate the correlation between mean platelet volume (MPV) and acute ischaemic cerebrovascular events (AICE) in haemodialysis (MHD)patients, and to evaluate the predictive value of MPV for AICE events. Methods Patients with maintenance MHD in the Nephrology Department of Beijing Chaoyang Hospital from January 2015 to December 2021 were collected as study subjects (n=232), and according to the occurrence of acute ischaemic cerebrovascular disease events they were divided into the AICE group (n=77) and non-AICE group (n=155). Differences in MPV and clinical features were compared between the two groups. Univariate and multivariate Cox regression was used to analyze the independent risk factors for AICE, and receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of MPV for the risk of AICE in MHD patients. Results Compared with the non-AICE group, patients in AICE group had significantly higher MPV[10.7 (10.3,11.3) fl vs. 10.3 (9.7,10.8) fl, Z=3.8938, P<0.001]. Age, smoking, history of CAD, 1-week mean ultrafiltration dehydrate volume, total cholesterol, LDL cholesterol, and triglyceride were all higher than those in non-AICE group, while albumin was lower than that in AICE group. Multivariate Cox regression showed that AIS history after correction, smoking, increased water removal by ultra-filtration, decreased albumin, and increased MPV [HR 1.601 (1.219, 2.102); P< 0.001] were independent risk factors for AICE. The AUC of the ROC curve on MPV was 0.824, the specificity was 0.883 and the sensitivity was 0.716. Conclusions MPV is an independent risk factor for AICE in MHD patients and has good predictive value for AICE.

Key words： mean platelet volume acute ischaemic cerebrovascular event hemodialysis

Received: 27 January 2024

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	MA Lijie
	HAN Qiuxia
	SUN Fang
	SUN Qianmei

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MA Lijie,HAN Qiuxia,SUN Fang等. Predictive value of mean platelet volume in acute ischemic cerebrovascular disease in hemodialysis patients[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(5): 399-404.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I5/399

[2]	Foley R N, Gilbertson D T, Murray T, et al. Long interdialytic interval and mortality among patients receiving hemodialysis[J]. N Engl J Med, 2011,365:1099-1107.
[1]	刘丽萍,周宏宇,段婉莹,等. 中国脑血管病临床管理指南(第2版)(节选)-第4章缺血性脑血管病临床管理推荐意见[J]. 中国卒中杂志,2023,18(8):910-933.
[3]	Power A, Chan K, Singh S K, et al. Appraising stroke risk in maintenance hemodialysis patients: a large single-center cohort study[J]. Am J Kidney Dis,2012,59:249-257.
[2]	Foley R N, Gilbertson D T, Murray T, et al. Long interdialytic interval and mortality among patients receiving hemodialysis[J]. N Engl J Med, 2011,365:1099-1107.
[4]	David A D, Mark J S. Ischemic and hemorrhagic stroke: high incidence in hemodialysis and peritoneal dialysis patients[J]. Am J Kidney Dis,2014,63(4):547-548.
[3]	Power A, Chan K, Singh S K, et al. Appraising stroke risk in maintenance hemodialysis patients: a large single-center cohort study[J]. Am J Kidney Dis,2012,59:249-257.
[5]	Thomas A M, Katherine G, David M C. Apixaban versus no anticoagulation in patients undergoing long-term dialysis with incident atrial fibrillation[J]. Clin J Am Soc Nephrol, 2020,15(8): 1146-1154.
[4]	David A D, Mark J S. Ischemic and hemorrhagic stroke: high incidence in hemodialysis and peritoneal dialysis patients[J]. Am J Kidney Dis,2014,63(4):547-548.
[6]	Fahad S, Malik M A, Gabriel A V. Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease[J]. Nephrol Dial Transplant,2016,31(1):128-132.
[5]	Thomas A M, Katherine G, David M C. Apixaban versus no anticoagulation in patients undergoing long-term dialysis with incident atrial fibrillation[J]. Clin J Am Soc Nephrol, 2020,15(8): 1146-1154.
[7]	James B W, Milind A P, Edward F E, et al. Relationship between stroke and mortality in dialysis patients[J]. Clin J Am Soc Nephrol,2015,10(1):80-89.
[6]	Fahad S, Malik M A, Gabriel A V. Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease[J]. Nephrol Dial Transplant,2016,31(1):128-132.
[8]	Findlay M D, Thomson P C, Fulton R L, et al. Risk factors of ischemic stroke and subsequent outcome in patients receiving hemodialysis[J]. Stroke, 2015,46(9):2477-2481.
[7]	James B W, Milind A P, Edward F E, et al. Relationship between stroke and mortality in dialysis patients[J]. Clin J Am Soc Nephrol,2015,10(1):80-89.
[9]	Sato K, Konta Y, Furuta K, et al. Prognostic factors for acute ischemic stroke in patients undergoing hemodialysis[J]. Clin Exp Nephrol, 2022,26(3):286-293.
[8]	Findlay M D, Thomson P C, Fulton R L, et al. Risk factors of ischemic stroke and subsequent outcome in patients receiving hemodialysis[J]. Stroke, 2015,46(9):2477-2481.
[10]	Korniluk A, Koper-Lenkiewicz O M, Kamińska J, et al. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions[J]. Mediators Inflamm, 2019:9213074.
[9]	Sato K, Konta Y, Furuta K, et al. Prognostic factors for acute ischemic stroke in patients undergoing hemodialysis[J]. Clin Exp Nephrol, 2022,26(3):286-293.
[11]	Norgaz T, Hobikoglu G, Aksu H, et al. The relationship between preprocedural platelet size and subsequent in-stent restenosis[J]. Acta Cardiol,2004,59:391-395.
[10]	Korniluk A, Koper-Lenkiewicz O M, Kamińska J, et al. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions[J]. Mediators Inflamm, 2019:9213074.
[12]	Yang A, Pizzulli L, Luderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris[J]. Thromb Res,2006,117:371-377.
[11]	Norgaz T, Hobikoglu G, Aksu H, et al. The relationship between preprocedural platelet size and subsequent in-stent restenosis[J]. Acta Cardiol,2004,59:391-395.
[13]	Oznur S, Ahmed M B. Early Change in platelet count and mpv levels of patients who received hemodialysis for the first time: mogadishu somalia experience[J]. Int J Clin Pract, 2022:1503227.
[12]	Yang A, Pizzulli L, Luderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris[J]. Thromb Res,2006,117:371-377.
[14]	M Asanuma, K Seino, T Mizuno, et al.Plasma thrombopoietin level and platelet indices in hemodialysis patients receiving recombinant human erythropoietin[J]. Int J Lab Hematol, 2010, 32(3):312-319.
[13]	Oznur S, Ahmed M B. Early Change in platelet count and mpv levels of patients who received hemodialysis for the first time: mogadishu somalia experience[J]. Int J Clin Pract, 2022:1503227.
[15]	Allan J C, Robert N F, Blanche C, et al. United States Renal Data System 2011 annual data report: Atlas of chronic kidney disease & end-stage renal disease in the United States[J]. Am J Kidney Dis, 2012, 59(Suppl 1):420.
[14]	M Asanuma, K Seino, T Mizuno, et al.Plasma thrombopoietin level and platelet indices in hemodialysis patients receiving recombinant human erythropoietin[J]. Int J Lab Hematol, 2010, 32(3):312-319.
[16]	Toyoda K, Fujii K, Fujimi S, et al. Stroke in patients on maintenance hemodialysis: a 22-year single-center study[J]. Am J Kidney Dis,2005,45:1058-1066.
[15]	Allan J C, Robert N F, Blanche C, et al. United States Renal Data System 2011 annual data report: Atlas of chronic kidney disease & end-stage renal disease in the United States[J]. Am J Kidney Dis, 2012, 59(Suppl 1):420.
[17]	Nauman T, Malik M A, Fahad S, et al. Outcomes of thrombolytic treatment for acute ischemic stroke in dialysis-dependent patients in the United States[J]. J Stroke Cerebrovasc Dis, 2013,22(8):e354-359.
[16]	Toyoda K, Fujii K, Fujimi S, et al. Stroke in patients on maintenance hemodialysis: a 22-year single-center study[J]. Am J Kidney Dis,2005,45:1058-1066.
[18]	Dearbhla M K, Zanfina A, Wolfram D, et al. Chronic kidney disease and cerebrovascular disease: consensus and guidance from a KDIGO Controversies Conference[J]. Stroke,2021,52(7):e328-e346.
[17]	Nauman T, Malik M A, Fahad S, et al. Outcomes of thrombolytic treatment for acute ischemic stroke in dialysis-dependent patients in the United States[J]. J Stroke Cerebrovasc Dis, 2013,22(8):e354-359.
[19]	Yuki S, Satoru M, Isao K, et al. Risk Factors and outcomes of cerebral stroke in end-stage renal disease patients receiving hemodialysis[J]. J Stroke Cerebrovasc Dis,2020,29(4):104657.
[18]	Dearbhla M K, Zanfina A, Wolfram D, et al. Chronic kidney disease and cerebrovascular disease: consensus and guidance from a KDIGO Controversies Conference[J]. Stroke,2021,52(7):e328-e346.
[20]	Findlay M D, Dawson J, Dickie D A, et al. Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients[J]. J Am Soc Nephrol,2019,30:147-158.
[19]	Yuki S, Satoru M, Isao K, et al. Risk Factors and outcomes of cerebral stroke in end-stage renal disease patients receiving hemodialysis[J]. J Stroke Cerebrovasc Dis,2020,29(4):104657.
[21]	Tilman B D, Patrick S P. Summary of the KDIGO guideline on anemia and comment: reading between the (guide)line(s)[J]. Kidney Int,2012,82(9):952-960.
[20]	Findlay M D, Dawson J, Dickie D A, et al. Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients[J]. J Am Soc Nephrol,2019,30:147-158.
[22]	Jackson S R, Carter J M. Platelet volume: laboratory measurement and clinical application[J]. Blood Rev, 1993, 7:104-113.
[21]	Tilman B D, Patrick S P. Summary of the KDIGO guideline on anemia and comment: reading between the (guide)line(s)[J]. Kidney Int,2012,82(9):952-960.
[23]	Choi C U, Seo H S, Kim Y K, et al. Can mean platelet volume predict coronary vasospasm?[J].Platelets, 2011,22:173-178.
[22]	Jackson S R, Carter J M. Platelet volume: laboratory measurement and clinical application[J]. Blood Rev, 1993, 7:104-113.
[24]	Berger J S, Eraso L H, Xie D, et al. Mean platelet volume and prevalence of peripheral artery disease, the national health and nutrition examination survey, 1999-2004[J]. Atherosclerosis,2010,213:586-591.
[23]	Choi C U, Seo H S, Kim Y K, et al. Can mean platelet volume predict coronary vasospasm?[J].Platelets, 2011,22:173-178.
[25]	Hong S P, Choi D H, Kim H W, et al. Stroke prevention in patients with non-valvular atrial fibrillation: new insight in selection of rhythm or rate control therapy and impact of mean platelet volume[J]. Curr Pharm Des, 2013,19(32):5824-5829.
[24]	Berger J S, Eraso L H, Xie D, et al. Mean platelet volume and prevalence of peripheral artery disease, the national health and nutrition examination survey, 1999-2004[J]. Atherosclerosis,2010,213:586-591.
[26]	Bayar N, Arslan S, Cagirci G, et al. Usefulness of mean platelet volume for predicting stroke risk in paroxysmal atrial fibrillation patients[J]. Blood Coagul Fibrinolysis,2015,26(6):669-672.
[25]	Hong S P, Choi D H, Kim H W, et al. Stroke prevention in patients with non-valvular atrial fibrillation: new insight in selection of rhythm or rate control therapy and impact of mean platelet volume[J]. Curr Pharm Des, 2013,19(32):5824-5829.
[27]	Troussard X, Vol S, Cornet E, et al. Full blood count normal reference values for adults in France[J]. J Clin Pathol,2014,67(4):341-344.
[26]	Bayar N, Arslan S, Cagirci G, et al. Usefulness of mean platelet volume for predicting stroke risk in paroxysmal atrial fibrillation patients[J]. Blood Coagul Fibrinolysis,2015,26(6):669-672.
[28]	Chu S G, Becker R C, Berger P B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis[J]. J Thromb Haemost,2010,8(1):148-156.
[27]	Troussard X, Vol S, Cornet E, et al. Full blood count normal reference values for adults in France[J]. J Clin Pathol,2014,67(4):341-344.
[29]	Anderson J, Abbuhl M, Hering T, et al. Immunohistochemical identification of components in thehealing response of human vascular grafts[J]. Asaio J, 1985, 8:79-85.
[28]	Chu S G, Becker R C, Berger P B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis[J]. J Thromb Haemost,2010,8(1):148-156.
[29]	Anderson J, Abbuhl M, Hering T, et al. Immunohistochemical identification of components in thehealing response of human vascular grafts[J]. Asaio J, 1985, 8:79-85.