静脉血栓栓塞症患者外周血嗜酸性粒细胞与血小板、凝血功能指标、C-反应蛋白的相关性分析

Correlation of peripheral blood eosinophils with platelets, coagulation parameters and C-reactive protein in patients with venous thromboembolism

目的:探讨静脉血栓栓塞症(VTE)患者外周血嗜酸性粒细胞(EOS)绝对计数与血小板(PLT)计数、凝血功能指标、C反应蛋白(CRP)的潜在相关关系。方法:回顾性收集2014年4月—2017年6月收治的908例深静脉血栓形成(DVT)和肺血栓栓塞症(PE)患者的临床资料和入院初次血液学检查结果,比较不同特征患者外周血EOS绝对计数、PLT计数、血浆凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、抗凝血酶Ⅲ活性(AT-Ⅲ)、CRP的变化,并分析EOS绝对计数与其他指标的相关性。结果:不同性别、不同DVT分型、不同分期患者的外周血EOS绝对计数不同,男性高于女性,混合型患者高于周围型患者,亚急性期和慢性期患者高于急性期患者(均P<0.05);所有其他指标也均在部分特征分组中存在明显差异(均P<0.05)。EOS绝对计数与PLT计数、PT、INR、APTT、D-D、CRP存在相关关系,且相关程度随着患者年龄的变化而变化(均P<0.05)。结论:EOS可通过多条途径激活和促进凝血,同时影响抗凝系统,最终导致血栓形成。不同类型VTE患者外周血EOS水平存在差异,EOS绝对计数与PLT、凝血功能指标、CRP表现出潜在的相关性,提示外周血EOS在VTE的病情判断和预后评估中具有一定的临床意义。

Objective: To investigate the potential correlation between absolute count of peripheral blood eosinophils (EOS) and platelet (PLT) count, coagulation parameters, and C-reactive protein (CRP) in patients with venous thromboembolism (VTE).Methods: The clinical data and results of hematological tests at the first time after admission of 908 patients with deep venous thrombosis (DVT) or pulmonary thromboembolism (PE) admitted from April 2014 to June 2017 were collected retrospectively. The differences of absolute peripheral blood EOS count along with PLT count, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (D-D), antithrombin Ⅲ(AT-Ⅲ) activity, and CRP among patients with different characteristics were compared, and the correlations between peripheral blood EOS count and all other above variables were analyzed.Results: The absolute peripheral blood EOS counts were significantly different between patients with different sex, different DVT classifications, different stages, which was in male patients significantly higher than that in female patients, in patients with mixed type significantly higher than that in patients with peripheral type, and in patient in subacute and chronic stage significantly higher than in patient in acute stage (all P<0.05); all other studied parameters also showed significant differences between or among groups stratified by some of the predefined characteristics (all P<0.05). The absolute peripheral blood EOS count was significantly correlated with PLT count, PT, INR, APTT, D-D, and CRP, and the degrees of correlation changed with the age of the patients (all P<0.05).Conclusion: EOS can induce thrombosis by activating the coagulation system through multiple pathways and meanwhile affecting the anticoagulant system. There are differences in peripheral blood EOS levels in VTE patients of different types, and peripheral blood EOS is potentially correlated with PLT count, coagulation parameters and CRP. The results suggest that peripheral blood EOS has certain clinical significance in the judgment of disease state and estimation of prognosis for VTE.