摘要
目的探讨高原地区与平原地区慢性阻塞性肺疾病(COPD)患者血小板计数、血小板平均体积(MPV)、血小板分布宽度(PDW)、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、C反应蛋白(CRP)指标的差异, 分析高原地区COPD患者血小板活化功能与动脉血气指标、CRP、肺动脉收缩压(PASP)的关系及临床意义。方法本研究为病例对照研究。选取2020年1月至2021年6月高原地区(青海大学附属医院)的COPD患者、COPD合并肺动脉高压(PH)患者各30例为研究对象, 并选取同时期平原地区(郑州大学第一附属医院)COPD患者、COPD合并PH患者各30例作为对照组, 分析4组患者的血小板计数、MPV、PDW、PaO_(2)、SaO_(2)、PaCO_(2)、PASP、CRP水平, 并分析MPV、PDW与动脉血气指标、CRP、PASP的相关性。结果无论高原组还是平原组, 均有COPD合并PH组的血小板、PaO_(2)、SaO_(2)较COPD组降低, MPV、PDW、PaCO_(2)、CRP、PASP较COPD组升高(P值均<0.05)。无论COPD组还是COPD合并PH组, 均有高原组的血小板计数、PaO_(2)、SaO_(2)、PaCO_(2)低于平原组, MPV、PDW、CRP、PASP高于平原组(P值均<0.05)。高原COPD组及高原COPD合并PH组中, 均有MPV与PaO_(2)呈负相关, 与PaCO_(2)、CRP、PASP呈正相关(P值均<0.05);PDW与PaO_(2)呈负相关, 与PaCO_(2)、CRP、PASP均呈正相关(P值均<0.05)。结论高原地区COPD患者及COPD合并PH患者血小板活化及炎症反应较平原地区更严重, 且血小板活化参与了COPD呼吸衰竭的发生、发展, 并促进系统炎症反应以及PH的形成。
Objective To compare the differences of platelet(PLT)count,mean platelet volume(MPV),platelet distribution width(PDW),partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),and C-reactive protein(CRP)between patients with chronic obstructive pulmonary disease(COPD)in plateau areas and in plain areas with or without pulmonary hypertension(PH),and to analyze the relationship between platelet activation function and arterial blood gas,CRP,and PASP in patients with COPD at high altitude and to analyze the clinical significance of these factors.Methods This was a case-control study.From January 2020 to June 2021,patients with COPD with or without pulmonary PH in plateau areas were selected from Qinghai University Affiliated Hospital(each with 30 cases)and those in plain areas were selected from the First Affiliated Hospital of Zhengzhou University(each with 30 cases as the controls).The levels of PLT,MPV,PDW,PaO_(2),SaO_(2),PaCO_(2),PASP,and CRP were analyzed in the four groups of patients,and the correlation of MPV and PDW with arterial blood gas index,CRP,and PASP was also analyzed.Results Compared with the COPD group,COPD combined with PH group showed lower PLT,PaO_(2),SaO_(2),and higher MPV,PDW,PaCO_(2),CRP,PASP in both plain or plateau areas(all P<0.05).PLT,PaO_(2),SaO_(2),PaCO_(2)were lower while MPV,PDW,CRP,PASP were higher in plateau than those in plain in both COPD group and COPD combined with PH group(all P<0.05).In plateau COPD group and plateau COPD combined with PH group,MPV was negatively correlated with PaO_(2)and positively correlated with PaCO_(2),CRP,and PASP(all P<0.05).PDW was negatively correlated with PaO_(2),while positively correlated with PaCO_(2),CRP,and PASP(all P<0.05).Conclusions Platelet activation and inflammation in COPD patients and in COPD with PH patients in plateau areas are more serious than those in plain areas.Platelet activation is involved in the occurrence and development of respiratory failure among COPD patients,and it can promote systemic inflammat
作者
孙兰
王佳岳
杨发菊
华毛
马维秀
Sun Lan;Wang Jiayue;Yang Faju;Hua Mao;Ma Weixiu(Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Panzhihua College,Panzhihua 617000,China;Department of Respiratory and Critical Care Medicine,Panzhihua Central Hospital,Panzhihua 617000,China;Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Qinghai University,Xining 810000,China)
出处
《国际呼吸杂志》
2022年第20期1556-1561,共6页
International Journal of Respiration
基金
青海省卫生健康委重点课题(2020-wjzd-04)。
关键词
肺疾病
慢性阻塞性
肺动脉高压
高原
血小板平均体积
血小板分布宽度
动脉血氧分压
Pulmonary disease,chronic obstructive
Pulmonary arterial hypertension
Plateau
Mean platelet volume
Platelet distribution width
Arterial partial pressure of oxygen
