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血液学参数与慢性阻塞性肺疾病严重程度之间的关系。

The relationship between hematological parameters and the severity level of chronic obstructive lung disease.

作者信息

Kalemci Serdar, Akin Fatih, Sarihan Aydin, Sahin Cem, Zeybek Arife, Yilmaz Nigar

出版信息

Pol Arch Intern Med. 2018 Jan 31;128(3):171-177. doi: 10.20452/pamw.4198.

DOI:10.20452/pamw.4198
PMID:29385111
Abstract

INTRODUCTION    Chronic obstructive pulmonary disease (COPD) is the most important lung disease leading to disability and even death. Recent studies have shown that the platelet indices are associated with several cardiovascular diseases; however, there is little data on COPD. OBJECTIVES    We aimed to explore the relationship between platelet indices, together with the platelet-to-lymphocyte ratio (PLR), white blood cell count to mean platelet volume ratio (WMR), and red cell distribution width (RDW) and the severity of COPD. PATIENTS AND METHODS    This retrospective study was based on data collected from a total of 153 COPD patients admitted to our outpatient clinic between March 2014 and March 2015. All of the participants underwent pulmonary function tests; FEV1, FVC, and FEV1/FVC were measured. The study population was divided into four according to the severity of COPD as group A (mild), group B (mild to moderate), group C (moderate to severe), and group D (severe).  RESULTS    A significant increase was found in platelet distribution width (PDW), MPV, plateletcrit, PLR, and RDW while WMR decreased as the COPD severity increases. In the multiple logistic regression analysis, we found that PDW and RDW were independently associated with the presence of severe COPD. ROC curve analysis showed that a PDW>14.85 was associated with severe COPD with 85% sensitivity and 86% specificity while RDW>14.45 was associated with severe COPD with 90% sensitivity and 87% specificity. CONCLUSIONS    The PDW and the RDW are independently associated with disease severity, which may indicate hypoxemia, underlying inflammation, and oxidative stress in COPD.

摘要

引言 慢性阻塞性肺疾病(COPD)是导致残疾甚至死亡的最重要的肺部疾病。最近的研究表明,血小板指标与几种心血管疾病有关;然而,关于COPD的数据却很少。

目的 我们旨在探讨血小板指标,以及血小板与淋巴细胞比值(PLR)、白细胞计数与平均血小板体积比值(WMR)和红细胞分布宽度(RDW)与COPD严重程度之间的关系。

患者和方法 这项回顾性研究基于2014年3月至2015年3月期间在我们门诊就诊的153例COPD患者收集的数据。所有参与者均接受了肺功能测试;测量了FEV1、FVC和FEV1/FVC。根据COPD的严重程度,研究人群分为四组:A组(轻度)、B组(轻度至中度)、C组(中度至重度)和D组(重度)。

结果 随着COPD严重程度的增加,血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板压积、PLR和RDW显著增加,而WMR降低。在多因素logistic回归分析中,我们发现PDW和RDW与重度COPD的存在独立相关。ROC曲线分析显示,PDW>14.85与重度COPD相关,敏感性为85%,特异性为86%;而RDW>14.45与重度COPD相关,敏感性为90%,特异性为87%。

结论 PDW和RDW与疾病严重程度独立相关,这可能表明COPD患者存在低氧血症、潜在炎症和氧化应激。

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