medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-018medsovet-8300Research ArticleПРИКЛАДНЫЕ АСПЕКТЫ ЭНДОКРИНОЛОГИИ И КАРДИОЛОГИИAPPLIED ASPECTS OF ENDOCRINOLOGY AND CARDIOLOGYТромбоцитарное звено гемостаза у полиморбидных пациентов с острым коронарным синдромом и COVID-19Platelet link of hemostasis in polymorbid patients with acute coronary syndrome and COVID-19https://orcid.org/0000-0002-2623-2657КадниковЛ. И.KadnikovL. I.

Кадников Леонид Игоревич, аспирант кафедры фармакологии и клинической фармакологии

620028, Екатеринбург, ул. Репина, д. 3

Leonid I. Kadnikov, Postgraduate Student, Department of Pharmacology and Clinical Pharmacology

3, Repina St., Yekaterinburg, 620109

kadn-leonid@mail.ruhttps://orcid.org/0000-0001-7826-9657ИзможероваН. В.IzmozherovaN. V.

Изможерова Надежда Владимировна, д.м.н., доцент, главный внештатный специалист – клинический фармаколог Министерства здравоохранения Свердловской области, заведующая кафедрой фармакологии и клинической фармакологии

620028, Екатеринбург, ул. Репина, д. 3

Nadezhda V. Izmozherova, Dr. Sci. (Med.), Associate Professor, Chief Freelance Specialist – Clinical Pharmacologist of the Ministry of Health of the Sverdlovsk Region, Head, Department of Pharmacology and Clinical Pharmacology

3, Repina St., Yekaterinburg, 620109

nadezhda_izm@mail.ruhttps://orcid.org/0000-0001-6216-2468ПоповА. А.PopovA. A.

Попов Артем Анатольевич, д.м.н., доцент, заведующий кафедрой госпитальной терапии и скорой медицинской помощи

620028, Екатеринбург, ул. Репина, д. 3

Artem A. Popov, Dr. Sci. (Med.), Associate Professor, Head, Department of Hospital Therapy and Urgent Medical Care Service

3, Repina St., Yekaterinburg, 620109

art_popov@mail.ruhttps://orcid.org/0000-0002-9957-2505АнтроповаИ. П.AntropovaI. P.

Антропова Ирина Петровна, д.б.н., ведущий научный сотрудник Центральной научно-исследовательской лаборатории

620028, Екатеринбург, ул. Репина, д. 3

Irina P. Antropova, Dr. Sci. (Biol.), Leading Researcher of the Central Research Laboratory

3, Repina St., Yekaterinburg, 620109

aip.hemolab@mail.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian Federation20242005202406267274Copyright © Кадников Л.И., Изможерова Н.В., Попов А.А., Антропова И.П., 20242024Кадников Л.И., Изможерова Н.В., Попов А.А., Антропова И.П.Kadnikov L.I., Izmozherova N.V., Popov A.A., Antropova I.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8300Введение

Введение. Тромбоциты играют ключевую роль в возникновении артериального тромбоза, а влияние SARS-CoV-2 на тромбоциты способствует повышенному риску тромбообразования. 

Цель

Цель. Оценить тромбоцитарное звено гемостаза, а также полиморбидность у пациентов с острым коронарным синдромом и COVID-19 на момент госпитализации.

Материалы и методы

Материалы и методы. Исследование «случай – контроль»; 96 пар пациентов с острым коронарным синдромом (ОКС), сопоставимых по полу, возрасту и диагнозу «ОКС». Группу 1 составили пациенты с ОКС и COVID-19, группу 2 – пациенты с ОКС без COVID-19. Показатели крови исследовали на гематологических анализаторах Mindray BC-5150 (China) и ABX Micros-60 (France), результаты которых были сопоставимы. Статистическая обработка выполнялась в среде Statistica 13.0. Работа одобрена локальным этическим комитетом ФГБОУ ВО УГМУ Минздрава России протоколом №9 от 22.10.2021.

Результаты

Результаты. Уровень тромбоцитов (PLT) в группе 1 составил 242 (178÷299) х 109/л, в группе 2 – 236 (199÷291) х 109/л, p = 0,927. Средний объем тромбоцитов (MPV) в группе 1 составил 10,0 (9,3÷11,5) фл, в группе 2 – 8,0 (7,6÷8,8) фл, p < 0,001. Ширина распределения тромбоцитов (PDW) в группе 1 составила 16,2 (15,9÷16,4), в группе 2 – 15,7 (14,7÷16,7), p < 0,001. Тромбокрит (PCT) в группе 1 составил 0,24 (0,18÷0,30)%, в группе 2 – 0,19 (0,16÷0,24)%, p < 0,001. Отношение абсолютного количества тромбоцитов к абсолютному количеству лимфоцитов (PLR) в группе 1 составило 159,4 (109,5÷232,9), в группе 2 – 118,4 (88,2÷158,1), p < 0,001. Индекс полиморбидности Charlson в группе 1 составил 5 (4÷6) баллов, в группе 2 – 4 (4÷6) балла, p = 0,047.

Выводы

Выводы. Более высокие значения MPV, PDW, PCT при равном уровне PLT, больший уровень PLR на момент поступления в стационар и большая полиморбидность могут свидетельствовать о более выраженной активации тромбоцитов за счет воспаления, выраженной иммуносупрессии и сопутствующих заболеваний у пациентов с COVID-19.

Introduction

Introduction. Platelets play an important role in arterial thrombosis, and the effects of SARS-CoV-2 on platelets contribute to an increased risk of thrombosis.

Aim

Aim. To evaluate platelet link of hemostasis system and polymorbidity in patients with acute coronary syndrome and COVID-19 at the time of admission to the hospital.

Materials and methods

Materials and methods. The case-control study included 96 pairs of patients with acute coronary syndrome (ACS). The groups were adjusted by gender, age and diagnosis of ACS. Group 1 had ACS and COVID-19, Group 2 had ACS without COVID-19. Blood indicators were examined using the Mindray BC-5150 and ABX Micros-60 automatic hematology analyzers, the results of which were comparable Statistica 13.0 environment was used for statistical processing. The study was approved by the Local Ethics Committee of Ural State Medical University by Protocol No. 9 dated 10.22.2021.

Results

Results. Platelet level (PLT) was 242 (178÷299) x 109/L Group 1 and 236 (199÷291) x 109/L, in Group 2, p = 0.927. Mean platelet volume (MPV) was 10.0 (9.3÷11.5) fl in Group 1 and 8.0 (7.6÷8.8) fl, in Group 2, p < 0.001. Platelet distribution width (PDW) was 16.2 (15.9÷16.4) in Group 1, and 15.7 (14.7÷16.7) in Group 2, p < 0.001. Plateletcrit (PCT) was 0.24 (0.18÷0.30)% in Group 1 and 0.19 (0.16÷0.24)% in Group 2, p < 0.001. Platelet-to-lymphocyte ratio (PLR) 159.4 (109.5÷232.9) in Group 1 and 118.4 (88.2÷158.1) in Group 2, p < 0.001. The Charlson polymorbidity index in Group 1 was 5 (4÷6) points, in Group 2 – 4 (4÷6) points, p = 0.047.

Conclusions

Conclusions. Higher PDW, MPV, PCT values with the same PLT, higher PLR level and higher polymorbidity at the time of hospitalization may indicate more pronounced platelet activation due to inflammation, severe immunosuppression and concomitant diseases in patients with COVID-19.

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The authors declare that there are no conflicts of interest present.