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老年慢性阻塞性肺疾病患者肌肉减少症与高凝状态的关联

Association between sarcopenia and hypercoagulability in elderly patients with chronic obstructive pulmonary disease.

作者信息

Tian Huijun, Cheng Yanwei, Qin Lijie, Zhang Peirong, Li Yun, Liang Bingwei

机构信息

Department of Emergency Medicine, People's Hospital of Henan Province, People's Hospital of Zhengzhou University, No. 7 Weiwu Road, Jinshui District, Zhengzhou City, 450003, Henan Province, China.

出版信息

Eur Geriatr Med. 2025 Aug 17. doi: 10.1007/s41999-025-01289-7.

Abstract

PURPOSE

Blood hypercoagulability is associated with poor prognosis in elderly patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore whether sarcopenia, a common disease among the elderly, could promote the hypercoagulable state in such patients.

METHODS

Elderly patients with stable-phase COPD were divided into the sarcopenia group (n = 192) and the non-sarcopenia group (n = 264). Sarcopenia was diagnosed according to the criteria for risk assessment, muscle mass measurement, muscle strength evaluation, and muscle function assessment. All patients were followed up for 18 months, and the acute exacerbation of COPD was recorded. The characteristics of COPD, coagulation function, and potential confounding factors during the stable and acute exacerbation phases were collected. Multivariate logistic or linear regression was used for data analysis.

RESULTS

Compared with the non-sarcopenia group, the levels of PLT and AT-III in patients of the sarcopenia group were significantly lower, while the levels of PAR, PT, APTT, FIB, and D-dimer were significantly higher during both the stable phase and the acute exacerbation phase of COPD. More importantly, compared with the non-sarcopenia group, the deterioration amplitudes of most coagulation indicators in patients of the sarcopenia group were significantly greater during the process of COPD developing from the stable phase to the acute exacerbation phase.

CONCLUSION

There is a significant correlation between sarcopenia and blood hypercoagulability in elderly patients with COPD. Sarcopenia seemingly has the potential to be a risk factor for the blood hypercoagulable state in such patients, but further verification is still needed.

摘要

目的

血液高凝状态与老年慢性阻塞性肺疾病(COPD)患者的不良预后相关。本研究旨在探讨老年常见疾病肌少症是否会促进此类患者的高凝状态。

方法

将老年稳定期COPD患者分为肌少症组(n = 192)和非肌少症组(n = 264)。根据风险评估、肌肉量测量、肌肉力量评估和肌肉功能评估标准诊断肌少症。对所有患者进行18个月的随访,记录COPD急性加重情况。收集稳定期和急性加重期COPD的特征、凝血功能及潜在混杂因素。采用多因素逻辑回归或线性回归进行数据分析。

结果

与非肌少症组相比,肌少症组患者在COPD稳定期和急性加重期的血小板(PLT)及抗凝血酶III(AT-III)水平显著降低,而纤溶酶原激活物受体(PAR)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及D-二聚体水平显著升高。更重要的是,与非肌少症组相比,肌少症组患者在COPD从稳定期发展至急性加重期的过程中,大多数凝血指标的恶化幅度显著更大。

结论

老年COPD患者的肌少症与血液高凝状态之间存在显著相关性。肌少症似乎有可能成为此类患者血液高凝状态的危险因素,但仍需进一步验证。

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