[慢性阻塞性肺疾病急性加重期患者血浆中的血小板因子4和β-血小板球蛋白]

[Platelet factor 4 and β-thromboglobulin in blood plasma of patients with acute exacerbation of chronic obstructive pulmonary disease].

作者信息

Wu Jing-feng, Yang Yuan-hua, Pang Bao-sen

机构信息

Department of Respiratory & Critical Care Medicine, Capital Medical University, Beijing, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2013 May 14;93(18):1378-82.

PMID:24025501

Abstract

OBJECTIVE

To explore the role of platelet factor 4 (PF4) and β-thromboglobulin (β-TG) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

METHODS

A total of 71 AECOPD patients and 50 chronic obstructive pulmonary disease (COPD) patients within a stable stage were admitted into Beijing Chaoyang Hospital from January 2008 to June 2010. And another 40 healthy volunteers were selected as control group. The data of demographics, arterial blood gas analysis and pulmonary function parameters was collected and analyzed. The plasma levels of PF4 and β-TG were measured by enzyme-linked immunosorbent assay (ELISA). Platelet count was measured by hematology analyzer. Statistical analysis was used for PF4, β-TG and platelet count. Spearman rank correlation was used for correlation analysis.

RESULTS

No differences in age and gender existed among the AECOPD, stable and control groups. The plasma level of PF4 in the AECOPD group (2.28 µg/L) was significantly higher than that of the stable group (2.01 µg/L) and control group (1.57 µg/L) (both P < 0.05). The level of β-TG in AECOPD was 2.32 µg/L and it was significantly higher than that of the stable group (1.85 µg/L) and control group (1.29 µg/L) (both P < 0.05). The differences in platelet counts were insignificant between the AEC OPD group ((196 ± 67) ×10(9)/L), stable group ((194 ± 50) ×10(9)/L) and control group ((190 ± 48) ×10(9)/L). AECOPD group was divided into moderate, severe and very severe groups by pulmonary function parameters. The levels of PF4 and β-TG in very severe group were significantly higher than those in moderate and severe groups (P < 0.05). A significant positive correlation was observed between PF4 and β-TG (r = 0.518, P < 0.01). The levels of PF4 and β-TG were negatively correlated with FEV1%, FEV1/FVC and PaO2 (all P < 0.05).

CONCLUSION

Abnormal platelet activation exists in AECOPD. And the levels of PF4 and β-TG may reflect the severity of AECOPD and can be used as the markers of estimating prethrombotic state.

摘要

目的

探讨血小板因子4（PF4）和β-血小板球蛋白（β-TG）在慢性阻塞性肺疾病急性加重期（AECOPD）患者中的作用。

方法

选取2008年1月至2010年6月在北京朝阳医院住院的71例AECOPD患者、50例稳定期慢性阻塞性肺疾病（COPD）患者，另选40名健康志愿者作为对照组。收集并分析人口统计学、动脉血气分析及肺功能参数数据。采用酶联免疫吸附测定（ELISA）法检测血浆PF4和β-TG水平，用血液分析仪检测血小板计数。对PF4、β-TG及血小板计数进行统计学分析，采用Spearman等级相关进行相关性分析。

结果

AECOPD组、稳定期组和对照组在年龄和性别上无差异。AECOPD组血浆PF4水平（2.28μg/L）显著高于稳定期组（2.01μg/L）和对照组（1.57μg/L）（均P<0.05）。AECOPD组β-TG水平为2.32μg/L，显著高于稳定期组（1.85μg/L）和对照组（1.29μg/L）（均P<0.05）。AECOPD组（（196±67）×10⁹/L）、稳定期组（（194±50）×10⁹/L）和对照组（（190±48）×10⁹/L）血小板计数差异无统计学意义。根据肺功能参数将AECOPD组分为中度、重度和极重度组。极重度组PF4和β-TG水平显著高于中度和重度组（P<0.05）。PF4与β-TG之间存在显著正相关（r=0.518，P<0.01）。PF4和β-TG水平与FEV1%、FEV1/FVC及PaO₂呈负相关（均P<0.05）。