血小板活化指标MPV、PDW与AECOPD合并呼吸衰竭的相关性分析

Correlation analysis of platelet activation indexes MPV,PDW and AECOPD complicated with respiratory failure

目的探讨血小板活化指标MPV、PDW对慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者的意义。方法收集广东医科大学附属医院2018年1月~2020年8月COPD患者107例并进行相关性分析。其中,AECOPD合并呼吸衰竭组:50例,AECOPD不合并呼吸衰竭组:57例,比较两组患者的年龄、性别、吸烟史、BMI、平均血小板体积(MPV)、血小板分布宽度(PDW)、白细胞计数(WBC)、中性粒细胞比例(NE)等指标的差异,探讨血小板活化指标MPV、PDW与AECOPD合并呼吸衰竭组的相关性。结果AECOPD合并呼吸衰竭组的二氧化碳分压(PaCO2)、血小板分布宽度(PDW)、中性粒细胞比例(NE)明显高于AECOPD不合并呼吸衰竭组,且差异有统计学意义(P<0.05);AECOPD合并呼吸衰竭组的氧分压(PaO2)、MPV明显低于AECOPD不合并呼吸衰竭组,且差异有统计学意义(P<0.05)。Spearman相关性分析显示:AECOPD患者MPV与PaO2有明显的正相关性(r=0.391,P=0.005),PDW与PaO2有明显的负相关性(r=-0.495,P=0.000)。采用二元Logistic回归分析显示:PDW增加、NE升高是AECOPD合并呼吸衰竭的危险因素。结论平均血小板体积(MPV)及血小板分布宽度(PDW)在AECOPD合并呼吸衰竭中可以反映缺氧程度,血小板分布宽度(PDW)增加、中性粒细胞比例(NE)升高是AECOPD合并呼吸衰竭的危险因素,通过抗血小板、抗感染治疗,可能降低AECOPD合并呼吸衰竭的发生风险,改善AECOPD患者的预后。

Objective To explore the significance of platelet activation indexes MPV and PDW in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure.Methods 107 patients with COPD in the affiliated Hospital of Guangdong Medical University from January 2018 to August 2020 were collected and analyzed.There were 50 cases in AECOPD with respiratory failure group and 57 cases in AECOPD without respiratory failure group.The differences of age,sex,smoking history,BMI,mean platelet volume(MPV),platelet distribution width(PDW),leukocyte count(WBC)and neutrophil ratio(NE)between the two groups were compared to explore the correlation between platelet activation indexes MPV,PDW and AECOPD with respiratory failure group.Results The partial pressure of carbon dioxide(PaCO2),PDW and NE in AECOPD with respiratory failure group were significantly higher than those in AECOPD without respiratory failure group,and the differences were statistically significant(P<0.05).The partial pressure of oxygen(PaO2)and MPV in AECOPD with respiratory failure group were significantly lower than those in AECOPD without respiratory failure group(P<0.05).Spearman correlation analysis showed that there was a significant positive correlation between MPV and PaO2 in patients with AECOPD(r=0.391).There was a significant negative correlation between PDW and PaO2(r=-0.495).Binary Logistic regression analysis showed that increased PDW and increased NE may be a risk factor for AECOPD complicated with respiratory failure.Conclusion MPV and PDW can reflect the degree of hypoxia in patients with respiratory failure in AECOPD.Increased PDW and increased NE are risk factors for respiratory failure in patients with AECOPD.Anti-platelet and anti-infection therapy may reduce the risk of AECOPD complicated with respiratory failure and improve the prognosis of AECOPD patients.