目的：探讨血小板微颗粒（ PMP）水平与颈动脉粥样硬化的关系，评价PMP在颈动脉粥样硬化形成中的作用。方法选取2014年9月—2016年2月在温州市人民医院神经内科就诊的门诊和住院患者187例，根据颈动脉超声检查结果分为颈动脉内膜中层厚度（IMT）正常组（n＝52）、 IMT增厚组（n＝70）和颈动脉硬化斑块组（n＝65）。采用流式细胞仪测定血清PMP水平，同时测定空腹血糖（FPG）、血清总胆固醇（TC）、血浆纤维蛋白原（ FG）、血小板计数（ PLT）等指标；颈动脉粥样硬化的影响因素分析采用多元Logistic逐步回归分析。结果3组性别、吸烟比例、 PLT间差异无统计学意义（P＞0．05），而年龄、收缩压（SBP）、 FPG、 TC、 FG、 PMP间差异有统计学意义（P＜0．05）。多元Logistic逐步回归分析结果显示，年龄〔OR＝1．387，95％CI （1．195，1．610）〕、 FPG 〔OR＝5．597，95％CI （1．695，18．469）〕、 TC 〔OR＝10．241，95％CI （2．727，38．455）〕、 PMP 〔OR ＝14．918，95％CI （3．145，70．765）〕是颈动脉粥样硬化的独立危险因素（P＜0．05）。结论 PMP是颈动脉粥样硬化的独立危险因素，在颈动脉粥样硬化的病理过程中具有重要的作用。%Objective To discuss the relationship between platelet microparticle ( PMP ) level and carotid atherosclerosis, and assess the role of PMP in the development of carotid atherosclerosis.Methods 187 outpatients and inpatient who received treatment in Department of Neurology of Wenzhou People′s Hospital from September 2014 to February 2016 were selected, according to results of carotid ultrasonography, they were divided into normal group of carotid intima-media thickness (IMT) (n=52), IMT thickening group (n=70) and carotid atherosclerotic plaque group (n=65) .Serum PMP level was measured by flow cytometry, and in the meanwhile fasting blood -glucose ( FPG ) , serum total cholesterol ( TC ) , plasma fibrinogen ( FG) , platelet count ( PLT) and other indicators were also measured; multiple Logistic stepwise regression analysis was used to analyze the influencing factors of carotid atherosclerosis.Results There was no significant difference in sex, smoking rate and PLT among the three groups (P>0.05), but there was significant difference in age, SBP, FPG, TC, FG and PMP (P<0.05) .Multiple Logistic stepwise regression analysis showed that age 〔OR=1.387, 95%CI (1.195, 1.610)〕, FPG〔OR=5.597, 95%CI (1.695, 18.469)〕, TC〔OR=10.241, 95%CI (2.727, 38.455)〕, PMP〔OR=14.918, 95%CI (3.145, 70.765)〕 were the independent risk factors of carotid atherosclerosis ( P <0.05 ).Conclusion PMP is the independent risk factor of carotid atherosclerosis, and it plays an important role in the pathological process of carotid atherosclerosis.
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