目的 探讨术前外周血血小板参数在原发性闭角型青光眼(PACG)中的变化及其意义.方法 本研究采用横断面病例对照研究设计.收集2014年1月～2017年6月于上海市徐汇区中心医院就诊并确诊为PACG的患者267例,同时收集同时间段于我院体检的正常人群254例作为正常对照组.采集纳入人群的年龄、性别、身高、体重、血压、血小板参数、疾病史等资料.采用全自动血细胞分析仪对外周血血小板参数进行检测.所纳入的PACG患者均进行详细的眼科检查.根据平均视野缺损(MD)大小,将PACG患者分为早期(MD≤6 dB)、中期(12 dB≥MD ＞6 dB)、晚期(MD＞ 12 dB) PACG亚组.采用独立样本t检验对PACG组及对照组2组间指标进行分析,采用方差分析对早期、中期、晚期PACG 3组间指标进行亚组分析.在单因素分析基础上,采用多因素Logistic回归分析对PACG与对照组间的血小板指标进行相关性分析.结果 PACG组与对照组间年龄、性别、体重指数、收缩压、舒张压和疾病史差异不具有统计学意义(P值均＞0.05).独立样本t检验分析结果显示:PACG患者外周血平均血小板体积(MPV)水平显著高于正常对照组[(10.41 ±1.41) fLvs.(9.93 ±0.97) fL],差异具有统计学意义(t=4.519,P＜0.001).PACG患者外周血血小板平均分布宽度(PDW)水平显著高于正常对照组[(15.26±2.39) fL vs.(14.65±2.59) fL],差异具有统计学意义(t=2.827,P=0.005).PACG患者外周血血小板计数(PLT)水平显著高于正常对照组[(209.29±56.63)×109/L vs.(198.31 ±57.18)×109/L],差异具有统计学意义(t=2.200,P=0.028).单因素方差分析显示:早期、中期、晚期PACG 3组间血小板参数差异不具有统计学意义(P值均＞0.05).二分类Logistic回归分析研究表明,MPV为PACG发病的独立危险因素(OR=1.341,P=0.003,95％可信区间为1.012 ～1.632).结论 PACG患者外周血血小板参数MPV、PDW、PLT水平显著升高,MPV可能与PACG的发生、发展存在相关性.%Objective To investigate the changes and significance of platelets in primary angle-closure glaucoma (PACG).Methods Cross-sectional,case-control study design.Study involved a total of 267 subjects which were enrolled for the study from January 2014 to June 2017 in Xuhui Central Hospital,and healthy individuals (n =254) as control.The peripheral blood platelet parameters were detected by automatic blood cell analyzer.A detailed eye examinations was performed for PACG patients.The data of subjects was collected.PACG was divided into mild,moderate and severe PACG,according to mean deviation (MD).Independent sample t test,one-way ANOVA test and multiple logistic regression analyses were used in this study.Results There was no statistical difference in age,sex,body mass index,systolic blood pressure,diastolic blood pressure and disease history between the groups (P ＞ 0.05).Independent samples t-test analysis results showed that the level of peripheral blood mean platelet volume (MPV) in PACG were significantly higher than that of normal control group (t =4.519,P ＜ 0.001).The level of average distribution width of platelet (PDW) in PACG patients was significantly higher than that of the normal control group (t =2.827,P =0.005).The level of platelet count (PLT) in PACG patients was significantly higher than that in the control group (t =2.200,P =0.028).There was no significant difference among mild,moderate and severe PACG.Multiple logistic regression analysis revealed that MPV (OR =1.341,P =0.003,95％ CI =1.012 ～ 1.632) was an independent risk factors in PACG.Conclusions The levels of MPV,PDW,PLT in PACG patients are significantly elevated,and MPV may be associated with onset and development of PACG.
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