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稳定期慢性阻塞性肺疾病男性患者血液学状况某些方面的评估

Assessment of Some Aspects of Hematological Status in Male Patients with Stable Chronic Obstructive Pulmonary Disease.

作者信息

Pervin M, Jahan K, Jahan S, Rashid H M A, Jelly A A, Fatema K

机构信息

Dr Magfura Pervin, Associate Professor, Department of Physiology, Tairunnessa Memorial Medical College and Hospital, Konia, Board Bazar, Gazipur, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2025 Jul;34(3):720-727.

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is one of the top three causes of death worldwide that induces an economic and social burden which is both substantial and increasing. Hematological status may be altered even in stable COPD and which is inversely related with the forced expiratory volume in first one second of expiration (FEV1). The objective of the study was to assessthe hematological status in stable COPD patients by counting their neutrophil, lymphocyte and platelet and to correlate them with FEV1. This cross-sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from January 2010 to December 2010. Sixty (60) male smoker (5-10 pack /year) patients of stable COPD (FEV₁/FVC% <0.70; FEV₁ ≤80%; without any exacerbation for last 4 weeks) were randomly selected from the Out Patient Door (OPD) of Medicine Department, BSMMU and a private clinic in Dhaka. On the basis of spirometric findings, 30 mild (Group B1) and 30 moderate stages (Group B2) of COPD patients with age 35-45 years were included in this study. As control (Group A) 30 apparently healthy male persons with matched age, BMI and smoking status were studied. Neutrophil and lymphocyte were counted manually by compound microscope, slide and Leishman's stain. Total count of platelet was counted manually by using hemocytometer and platelet counting fluid through direct method. Data was expressed as mean±SD. The mean±SD of neutrophil were 52.3±4.82, 57.3±5.09 and 71.0±5.5; lymphocyte were 30.7±5.37, 28.4±6.98 and 22.5±4.40% and platelet count were 207.3±19.66, 242.5±40.32 and 281.8±55.46 per mm³ of blood in Group A, B₁ and B₂ respectively. For statistical analysis Independent sample t-test and Pearson's Correlation Coefficient test were performed, as applicable and p<0.05 was accepted as significant. In this study, the mean values of differential count of neutrophil were higher and lymphocytes were lower in both the study groups than control and also in B₂ to that of the B₁. The mean values of platelet were higher in both control and also in B₂ to that of the B₁. These differences of mean values among the groups were statistically significant at (p<0.001) in A vs. B₁ and A vs. B₂ but at (p<0.01) in B₁ vs. B₂. However, this result was non significant for lymphocyte count in B₁. Hematological status altered in stable COPD and this alteration is inversely related to the severity of the disease.

摘要

慢性阻塞性肺疾病(COPD)是全球三大死因之一,会造成巨大且不断增加的经济和社会负担。即使在稳定期COPD患者中,血液学状态也可能发生改变,且与第一秒用力呼气量(FEV1)呈负相关。本研究的目的是通过计数稳定期COPD患者的中性粒细胞、淋巴细胞和血小板来评估其血液学状态,并将这些指标与FEV1进行关联分析。本横断面研究于2010年1月至2010年12月在孟加拉国班加班杜·谢赫·穆吉布医科大学(BSMMU)生理学系开展。从BSMMU医学科门诊和达卡一家私人诊所中随机选取60名稳定期COPD男性吸烟者(每年吸烟5 - 10包),这些患者符合FEV₁/FVC% <0.70;FEV₁≤80%;且在过去4周内无任何病情加重情况。基于肺功能检查结果,纳入了30例年龄在35 - 45岁的轻度COPD患者(B1组)和30例中度COPD患者(B2组)。选取30名年龄、体重指数和吸烟状况相匹配的明显健康男性作为对照(A组)。中性粒细胞和淋巴细胞通过复式显微镜、载玻片和利什曼染色进行手工计数。血小板总数通过血细胞计数板和血小板计数液采用直接法进行手工计数。数据以平均值±标准差表示。A组、B1组和B2组每立方毫米血液中中性粒细胞的平均值±标准差分别为52.3±4.82、57.3±5.09和71.0±5.5;淋巴细胞分别为30.7±5.37、28.4±6.98和22.5±4.40%;血小板计数分别为207.3±19.66、242.5±40.32和281.8±55.46。根据适用情况进行独立样本t检验和Pearson相关系数检验,p<0.05被认为具有统计学意义。在本研究中,两个研究组中性粒细胞分类计数的平均值均高于对照组,淋巴细胞平均值低于对照组,且B2组低于B1组。对照组以及B2组的血小板平均值均高于B1组。组间这些平均值的差异在A组与B1组以及A组与B2组比较时具有统计学意义(p<0.001),但在B1组与B2组比较时为(p<0.01)。然而,B1组淋巴细胞计数结果差异无统计学意义。稳定期COPD患者的血液学状态发生改变,且这种改变与疾病严重程度呈负相关。

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