血小板水平与COPD患者低危肺栓塞住院死亡的相关性分析  

CORRELATION BETWEEN PLATELET LEVEL AND INPATIENT MORTALITY IN LOW-RISK PULMONARY EMBOLISM IN PATIENTS WITH COPD

作　　者：黎银焕[1] 张平[1] 孔沛良 陈卫民[1] Li Yinhuan;Zhang Ping;Kong Peiliang(Department of Respiratory and Critical Care Medicine,People's Hospital of Dongguan,Dongguan 523000,China)

机构地区：[1]广东省东莞市人民医院呼吸与危重症医学科,523000

出　　处：《中国煤炭工业医学杂志》2020年第3期247-251,共5页Chinese Journal of Coal Industry Medicine

基　　金：广东省自然科学基金项目(编号:2016A030310111)。

摘　　要：目的分析血小板水平与慢性阻塞性肺疾病(COPD)患者低危肺栓塞(PE)住院死亡的相关性。方法回顾性分析2018年6月—2019年6月我院收治的60例COPD合并低危肺栓塞患者,按照血小板水平(PLT)分为观察组(PLT>400×10^9,n=34)和对照组(PLT≤400×10^9,n=26),收集患者临床资料,分析血小板水平与呼吸困难量表(mMRC)评分、预后的相关性,并采用Logistic回归分析影响COPD合并低危肺栓塞患者3个月内死亡的高危因素。结果观察组合并心脑血管疾病概率高于对照组,差异有统计学意义(P<0.05);观察组心率、心肌肌钙蛋白1、脑钠肽、C反应蛋白(CRP)高于对照组,动脉血氧分压(PaO2)低于对照组,差异有统计学意义(P<0.05);观察组院内mMRC评分、病死率高于对照组(P<0.05);Pearson相关分析显示,血小板计数与COPD合并低危肺栓塞患者mMRC评分呈正相关(r=0.436,P<0.05),Spearman相关性分析显示,血小板计数与低危肺栓塞患者病死率呈正相关(r=0.501,P<0.05);多因素Logistic回归分析发现心肌肌钙蛋白Ⅰ、mMRC评分、血小板计数偏高是COPD合并低危肺栓塞院内死亡的独立危险因素(P<0.05)。结论血小板升高是影响COPD患者低危肺栓塞院内死亡的高危因素,针对此类高危患者进行抗血小板治疗有望降低死亡风险。Objective To analyze the correlation between platelet levels and inpatient mortality for low-risk pulmonary embolism(PE)in patients with chronic obstructive pulmonary disease(COPD).Methods A retrospective analysis of sixty patients with COPD and low-risk pulmonary embolism admitted to People’s Hospital of Dongguan from June 2018 to June 2019 was performed and divided into observation group(PLT>400×10^9,n=34)and control group(PLT≤400×10^9,n=26)according to platelet level(PLT).The clinical dataof patients was collected.The correlation between platelet level(PLT)and Modified Medical Research Council Dyspnea Scale(mMRC),prognosis was analyzed.Logistic regression was used to analyze the high-risk factors affecting death in patients with COPD combined with low-risk pulmonary embolism within 3 months.Results The probability of combined cerebrovascular disease was higher than that of the control group(P<0.05).The heart rate,cardiac troponin 1,brain natriuretic peptide and CRP were higher in the observation group than in the control group,and PaO2 was lower than the control group(P<0.05).The in-hospital mortality and mMRC scores in the observation group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that platelet count was related to mMRC score in patients with COPD combined with low-risk pulmonary embolism(r=0.436,P<0.05).Spearman correlation analysis showed that platelet count was positively correlated with the mortality in patients with low-risk pulmonary embolism(r=0.501,P<0.05).Multivariate Logistic regression analysis showed that cardiac troponin I,mMRC score,and high platelet count were independent risk factors for in-hospital mortality in patients with COPD complicated with low-risk pulmonary embolism(P<0.05).Conclusion Platelet elevation is a high-risk factor for in-hospital mortality in patients with low-risk pulmonary combined with COPD.Antiplatelet therapy for such high-risk patients has the potential to reduce the risk of death.

关 键 词：血小板 慢性阻塞性肺疾病 肺栓塞 预后 

分 类 号：R563.9[医药卫生—呼吸系统]