Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Ningxia Medical University (The First People's Hospital of Yinchuan), Yinchuan, Ningxia, China.
Department of Traditional Chinese Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
Heart Lung. 2023 Jan-Feb;57:54-58. doi: 10.1016/j.hrtlng.2022.08.013. Epub 2022 Aug 31.
There is limited research on clinical indicators for clinicians to judge the hypercoagulability of COPD patients.
The aim in this study was to evaluate the level changes of fibrinogen (FIB), d-dimer (D-D), and mean platelet volume (MPV) in plasma during the stable phase of chronic obstructive pulmonary disease (COPD), as compared with acute exacerbation of COPD (AECOPD).
A total of 240 patients admitted with COPD in our hospital and 60 healthy people were enrolled in this prospective study using data from August 2016 to August 2017. Patients were allocated to AECOPD or stable COPD group. The levels of white blood cell (WBC) count, absolute neutrophil counts (NEU%), activated partial thromboplastin time (APTT), prothrombin time (PT), and hypoxia inducible factor-1(HIF-1) were detected. The MPV, D-D, and the FIB level were also determined and compared between groups.
The WBC count, NEU%, FIB, and D-D were significantly higher in the AECOPD group than in the stable COPD group and the healthy group (P < 0.05), while the MPV, APTT and PT was significantly lower in the AECOPD group than in the stable COPD group and the healthy group (P < 0.05). Additionally, MPV was significantly negatively correlated with WBC count (r=-0.798) and NEU% (r=-0.749) in the AECOPD group (P < 0.05); and the percentage of forced expiratory volume in one second (FEV1) in the predicted value was significantly negatively correlated with D-D (r=-0.891) and FIB (r=-0.656) (P <0.05).
We demonstrated that, for patients hospitalized for exacerbation of COPD, MPV may indeed be a valid indicator of inflammation and a marker of thrombosis.
目前，针对临床医生判断 COPD 患者高凝状态的临床指标研究较少。
本研究旨在评估慢性阻塞性肺疾病（COPD）稳定期与急性加重期（AECOPD）患者血浆中纤维蛋白原（FIB）、D-二聚体（D-D）和平均血小板体积（MPV）水平的变化。
本前瞻性研究纳入了 2016 年 8 月至 2017 年 8 月我院收治的 240 例 COPD 患者和 60 例健康对照者，根据病情分为 AECOPD 组和稳定 COPD 组。检测白细胞（WBC）计数、中性粒细胞绝对值（NEU%）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）和低氧诱导因子-1（HIF-1）水平。比较两组间 MPV、D-D 和 FIB 水平。
AECOPD 组患者的 WBC 计数、NEU%、FIB 和 D-D 明显高于稳定 COPD 组和健康对照组（P<0.05），MPV、APTT 和 PT 明显低于稳定 COPD 组和健康对照组（P<0.05）。此外，AECOPD 组患者的 MPV 与 WBC 计数（r=-0.798）和 NEU%（r=-0.749）呈显著负相关（P<0.05）；一秒用力呼气容积占预计值百分比（FEV1%）与 D-D（r=-0.891）和 FIB（r=-0.656）呈显著负相关（P<0.05）。
我们发现，对于因 COPD 加重而住院的患者，MPV 可能确实是炎症的有效指标和血栓形成的标志物。
