[Changes of platelet aggregability in patients with subcortical ischemic vascular disease]

Objective: To explore the change and value of platelet aggregability(PA)in patients with subcortical ischemic vascular disease (SIVD). Methods: A total of 108 patients with SIVD hospitalized in the Department of Neurology of the First Affiliated Hospital of Anhui Medical University from October 2015 to July 2017 were enrolled as SIVD group and 30 healthy cases were also in cluded as normal controlgroup (NC). According to magnetic resonance imaging(MRI), the SIVD group was further divided into two subtypes: lacunar infarction(LI) (n=31)and leukoaraiosis(LA) (n=77). The severity of LA was further graded according to the Fazekas scale. The maximum aggregation rate of platelets was measured by optical turbidimetry, respectively, using four arachidonic acid (ACA), two adenosine monophosphate (ADP) and collagen (COLL) as inducerin all subjects. The change of PA between the subtypes of SIVD and NC were compared, and the relationship between PA and the severity of LA was analyzed. Results: The level of PA in SIVD was significantly higher than those in NC (P<0.001). In comparison with NC, the level of PA was significantly higher in both LI and LA subgroups(P<0.05). Meanwhile, there was no significant difference between LA group and LI group (P>0.05). Moreover, between LA groups, the PA induced by COLL were significantly different between the LA3 group and the LA1 group (P=0.026). Correlation analysis showed that ageand the level of PA induced by COLL was positively correlated with LA grade (r=0.382, P=0.001; r=0.260, P=0.026). Multivariate logistic regression analysis revealed that after controlling for various factors, when induced by ACA, the risk of SIVD in the highest group (>86.80%) and higher group (82.63%-86.80%) was 13.95 and 3.09 times respectively higher than in the normal group(<82.63%), the differences were statistically significant (P<0.001, P=0.038); when induced by ADP, the risk of SIVD in the highest group (>87.63%) and higher group (82.80%-87.63%) was 20.78 and 5.85 times respectively higher than in the normal group (<82.80%), the differences were statistically significant (P<0.001, P=0.003); When induced by COLL, the risk of SIVD in the highest group (>87.60%) and higher group (83.80%-87.60%)was 28.53 and 9.02 times respectively higher than in the normal group (<83.80%), the differences were statistically significant (P<0.001, P=0.002). Conclusions: The increasedlevel of PA is an independent risk factor of SIVD and closely related with the severity of LA .This study provides a theoretical basis for further understanding of the SIVD's pathogenesis and for the prevention and treatment of SIVD in the clinical practice.