炎性指标对慢阻肺患者高凝状态的预测价值  

The Predictive Value of lnflammatory Markers to Hypercoagulable State in COPD Patients

作　　者：薛冰蓉[1] 杨渝伟[1] 冯跃 唐洁[1] 徐鹏[1] XUE Bing-rong;YANG Yu-wei;FENG Yue(Department of Clinical Laboratory,Mianyang Central Hospital,Sichuan Mianyang 621000)

机构地区：[1]绵阳市中心医院检验科,四川绵阳621000

出　　处：《医学检验与临床》2019年第7期16-19,共4页Medical Laboratory Science and Clinics

摘　　要：目的:探讨中性粒细胞相对值(Neut%)、超敏C反应蛋白(hsCRP)及降钙素原(PCT)对慢性阻塞性肺疾病(COPD)患者高凝状态的预测价值.方法:采用回顾性分析2017年1月~2018年12月已确诊的COPD住院患者451例,入院时常规检测血细胞分析、hsCRP、PCT和D-二聚体(D-D).依据不同年龄D-D排除静脉血栓栓塞症(VTE)的临界值为界限,将患者分为高凝状态组(236例)和非高凝状态组(215例).采用Pearson相关分析上述炎性指标与D-D的相关性,交叉表分析各炎性指标对COPD 患者高凝状态的风险程度,受试者工作曲线分析各炎性指标对COPD患者高凝状态的预测价值.结果: 451例COPD患者的Neut%、hsCRP和PCT结果与D-D结果呈正相关(r分别为0.494、0.568和0.651,均P<0.001);三项炎性指标预测高凝状态的OR分别为5.467、5.884和11.821,判断界值分别为86.34%、8.84mg/L和0.117μg/L,尤登指数分别为0.407、0.494 和0.520.结论:Neut%、hsCRP和PCT三项炎性指标可能是COPD患者发生VTE的危险因素;当任意一项结果升高时,临床医生应对患者进行VTE的进一步确诊并及时干预.Objective: The aim of the present study is to investigate the predictive value of neutrophil relative value (Neut%), high-sensitivity C-reactive protein (hsCRP) and procalcitonin (PCT) in hypercoagulable state in patients with chronic obstructive pulmonary disease (COPD). Methods: A retrospective analysis of 451 patients with COPD hospitalized from January 2017 to December 2018 was performed. Hemanalysis, hsCRP, PCT, and D-dimer ( D-D) were routinely examined at admission. Patients were divided into hypercoagulable state group (236 cases) and non-hypercoagulated state group (215 cases) according to the threshold of D-D to exclude venous thromboembolism (VTE) at different age. Pearson correlation analysis was used to analyze the correlation between inflammatory markers and D-D. Cross-tabulation was used to analyze the risk of hyperinflammatory state of inflammatory markers in COPD patients. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of inflammatory markers to hypercoagulable state in COPD patients. Results: The value of Neut%(r=0.494, P<0.001), hsCRP (r=0.568, P<0.001) and PCT (r=0.651, P<0.001) were positively correlated with that of D-D in 451 COPD patients. Neut%(OR=5.467), hsCRP (OR=5.884) and PCT (OR=11.821) predicted the hypercoagulable state with the judgement thresholds of 86.34%, 8.84 mg/L, and 0.117 μg/L, respectively. The Youden index of the above-mentioned inflammatory markers was 0.407, 0.494, and 0.520, respectively. Conclusion: Neut%, hsCRP and PCT might be the risk factors of VTE in patients with COPD. When any of them is higher than the threshold in patients, the clinician should further diagnose with VTE and take intervention by taking timely and effective steps.

关 键 词：慢性阻塞性肺疾病 高凝状态 炎性指标 

分 类 号：R692[医药卫生—泌尿科学]