肺栓塞的患病率和危险因素在COPD患者中复杂的二次多细胞血症
Jimei Li1, Yulin Xiong1, Shengyan Li1
1General Medicine Department, Qinghai Provincial People's Hospital, Xining, Qinghai, People's Republic of China.
International journal of chronic obstructive pulmonary disease
|November 8, 2024
概括
肺栓塞 (PE) 影响5.21%的慢性阻塞性肺病 (COPD) 患者的二次多细胞血症 (SP). 活化蛋白C (APC) 和组织因子 (TF) 等生物标志物是关键的风险因素,但临床治疗可以降低这些风险.
科学领域:
- 肺部医学 肺部医学
- 血液学 血液学 血液学
- 心脏病学 心脏病学
背景情况:
- 慢性阻塞性肺病 (COPD) 和二次多细胞血症 (SP) 是严重的健康问题.
- 慢性肺炎和多发性脊髓炎的同时发生在患者管理中带来了独特的挑战.
- 肺栓塞 (PE) 是一种严重的并发症,需要在这个患者群体中进一步调查.
研究的目的:
- 确定慢性阻塞性肺病 (COPD) 和二次多细胞血症 (SP) 患者肺栓塞 (PE) 的患病率.
- 在COPD患者中识别与PE相关的风险因素,这些患者也患有SP.
- 评估临床治疗对COPD患者中已识别的生物标志物的影响.
主要方法:
- 对 SP 的住院 COPD 患者的回顾性分析 (2015 年 1 月 - 2020 年 12 月).
- 对实验室,生物标志物,心声和肺功能测试的三组 (COPD+SP+PE,COPD+SP,对照组) 的预期招生 (2021年1月 - 2024年1月).
- 在COPD+SP组治疗后七天重复测量生物标志物.
主要成果:
- 发现COPD患者中PE的患病率为5.21%.
- 红细胞分布宽度 (RDW),血小板分布宽度 (PDW),平均血小板体积 (MPV),中性粒细胞与淋巴细胞比率 (NLR),血小板与淋巴细胞比率 (PLR),淋巴细胞与单细胞比率 (LMR),单细胞与大血小板比率 (MLPR),5-氧三胺 (5-HT),激活蛋白C (APC),泌尿酸酶类型等离子素激活剂 (u-PA),血栓激素 (TM),介质素-38 (IL-38),组织因子 (TF) 和裂素 (FKN) 在COPD+SPEP组中与COPD+SPEP组相比观察到较高的水平.
- 特定的生物标记物包括FKN,β-血栓球蛋白 (β-TG),APC,u-PA,TM,TF和IL-38被确定为COPD患者中PE的风险因素. 临床治疗导致β-TG,IL-38,APC,内甲素-1 (ET-1),u-PA,FKN,TM,5-HT和中性粒细胞外细胞陷 (NET) 的显著减少.
结论:
- 在患有COPD和SP的患者中,PE更常见.
- 血液标志物,心脏标志物,血液气体分析和肺功能测试的综合评估有助于在COPD患者中检测PE.
- 在这个人群中,APC,u-PA,TF,FKN,TM和IL-38是PE的重要风险因素,治疗干预可以有效地减轻这些风险.
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