Białas Adam J, Pedone Claudio, Piotrowski Wojciech J, Antonelli Incalzi Raffaele
Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.
Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland.
Int J Chron Obstruct Pulmon Dis. 2017 Aug 1;12:2261-2267. doi: 10.2147/COPD.S131868. eCollection 2017.
Platelets may actively participate in inflammation in COPD. Platelet distribution width (PDW), a measure of platelets' volume heterogeneity, may increase in platelets' activation. We hypothesized that PDW may be a marker of hypercoagulation, which plays a significant role in conditions associated with worse survival of patients with COPD, eg, acute myocardial infarction and other forms of ischemic heart disease.
Retrospective analysis of 79 patients. Variables were compared after grouping patients according to the upper normal limit of PDW, using Welch's -tests or Mann-Whitney , and chi-square tests. Survival in the two groups was compared using the Kaplan-Meier method and Cox proportional hazards regression.
Ten patients presented values of PDW above 16 fL, which was the upper limit of normality for our laboratory. Compared to patients with normal PDW, they had lower forced expiratory flow between 25% and 75% of vital capacity (FEF 25-75) - 35% of reference value vs 57% (=0.003) and peak expiratory flow - 39% vs 54% (<0.001). The median survival of patients with elevated PDW was 743 days compared to those with normal PDW (1,305 days) (=0.025). The adjusted HR was 4.59 (95% CI: 1.1, 19.19; =0.04).
Our analysis indicates that elevated PDW is associated with reduced survival of patients with COPD. If our data are to be confirmed, PDW may be used as an inexpensive and repeatable prognostic tool in COPD.
血小板可能积极参与慢性阻塞性肺疾病（COPD）的炎症反应。血小板分布宽度（PDW）是衡量血小板体积异质性的指标，在血小板激活时可能会增加。我们假设PDW可能是高凝状态的一个标志物，高凝状态在与COPD患者生存率降低相关的疾病中起重要作用，如急性心肌梗死和其他形式的缺血性心脏病。
对79例患者进行回顾性分析。根据PDW的正常上限对患者进行分组后，使用韦尔奇t检验或曼-惠特尼U检验以及卡方检验对变量进行比较。使用Kaplan-Meier方法和Cox比例风险回归比较两组的生存率。
10例患者的PDW值高于16 fL，这是我们实验室的正常上限。与PDW正常的患者相比，他们在肺活量的25%至75%之间的用力呼气流量（FEF 25-75）较低——参考值的35%对57%（P=0.003），呼气峰值流量较低——39%对54%（P<0.001）。PDW升高的患者中位生存期为743天，而PDW正常的患者为1305天（P=0.025）。调整后的风险比为4.59（95%置信区间：1.1，19.19；P=0.04）。
我们的分析表明，PDW升高与COPD患者生存率降低有关。如果我们的数据得到证实，PDW可能作为COPD中一种廉价且可重复的预后工具。
