慢性阻塞性肺疾病急性加重期血小板活化与感染性炎症的关系

The relationship between platelet activation and infective inflammation in patients with COPD

目的探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血小板活化膜糖蛋白GPⅡb/Ⅲa、GMP-140的变化及其与感染性炎症的关系。方法用三色全血流式细胞术测定44例AECOPD患者及44例缓解期患者外周血中血小板GPⅡb/Ⅲa、GMP-140的表达水平,并检测患者高敏C反应蛋白(hs-CRP)水平,与40例健康对照者比较。结果AECOPD组GPⅡb/Ⅲa、GMP-140、hs-CRP分别为(68.73±7.87)%、(43.36±7.92)%、(8.52±5.71)mg/L,均明显高于缓解期组[(51.86±7.59)%、(33.63±7.63)%、(4.85±2.39)mg/L]及健康对照组[(48.73±5.55)%、(30.63±4.09)%、(4.38±2.41)mg/L](P均<0.001)。AECOPD组GPⅡb/Ⅲa与hs-CRP呈正相关(r=0.55,P<0.005),GMP-140与hs-CRP呈正相关(r=0.49,P<0.005)。结论AECOPD患者血小板明显活化,血小板活化与感染性炎症反应之间关系密切,活化血小板对AECOPD患者炎症反应起一定作用。

Objective To investigate the relationship among platelet activation markers （GP Ⅱb/Ⅲa and GMP-140）and high-sensitivity C-reactive protein （hs-CRP） in elderly patients with chronic obstructive pulmonary disease （COPD）. Methods Subjects were divided into three groups： 44 patients with AECOPD, 44 patients with remission, 40 cases of healthy controls. Positive rates of GP Ⅱb/Ⅲa and GMP-140 were measured with tricolor flow cytometry. Hs-CRP in patients with COPD and healthy controls were also determined. Results The levels of GP Ⅱb/Ⅲa, GMP-140 and hs-CRP in AECOPD group were （68.73±7.87 ） %, （43.36 ±7.92 ） % and （ 8.52 ±5.71 ） mg/L, respectively, which increased significantly （ P all 〈0.001 ）, compared with COPD remission group with GP Ⅱb/Ⅲa （51.86 ±7.59）% , GMP-140 （33.63 ±7.63） % and hs-CRP （4.85 ±2.39） mg/L, while healthy group with GP Ⅱb/Ⅲa （48.73 ±5.55） %, GMP-140 （30.63 ±4.09） %, hs-CRP （4.38 ±2.41 ） mg/L. Hs-CRP levels in AECOPD group were positive to GP Ⅱb/Ⅲa （ r = 0. 55, P 〈 0. 005 ） and GMP-140 （ r = 0. 49, P 〈 0. 005 ）. Conclusions The platelet in patients with AECOPD is at the overactivated state. There is a relation between platelet activation and infective inflammation in patients with AECOPD and activated platelet might play a role in infective inflammation associated with AECOPD.