慢性阻塞性肺疾病稳定期患者炎症反应和血栓前状态的关系研究  

Relationship between inflammatory response and prothrombotic state in patients with stable COPD

作　　者：聂文朕 王欣雨 尹春燕 NIE Wenzhen;WANG Xinyu;YIN Chunyan(Department of Respiratory and Critical Care Medicine,The First People′s Hospital of Zigong,Zigong,Sichuan 643000,China;Department of Pharmacy,The First People′s Hospital of Zigong,Zigong,Sichuan 643000,China;Department of Nephrology,The Third People′s Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院呼吸与危重症医学科,四川自贡643000 [2]自贡市第一人民医院药剂科,四川自贡643000 [3]自贡市第三人民医院肾病内科,四川自贡643000

出　　处：《临床肺科杂志》2025年第5期677-680,共4页Journal of Clinical Pulmonary Medicine

基　　金：四川省医学科研课题(S19046)。

摘　　要：目的分析慢性阻塞性肺疾病(简称慢阻肺)稳定期患者炎症反应和血栓前状态的关系。方法于2020年4月至2024年4月选取我院106例慢阻肺稳定期患者与同时期入院体检的健康者100例作为本次调查对象,分别归为慢阻肺组与健康对照组,分别比较两组一般资料、肺功能[一秒用力呼气量(FEV_(1))、FEV_(1)%]、炎症指标[C-反应蛋白(CRP)、白细胞介素(IL-6)]、血栓前状态[血管性血友病因子(vWF)、血管性血友病因子裂解酶(ADAMTS-13)、D-二聚体]等,并采用Spearman直线相关分析法分析慢阻肺稳定期患者炎症反应和血栓前状态的关系。结果肺功能比较,慢阻肺组FEV_(1)、FEV_(1)%显著低于健康对照组(P<0.05);炎症指标比较,慢阻肺健康组CRP、IL-6显著高于健康对照组(P<0.05);血栓前状态比较,慢阻肺健康组vWF、D-二聚体水平显著高于健康对照组,但ADAMTS-13显著低于健康对照组(P<0.05);相关性分析显示,慢阻肺健康稳定期患者CRP、IL-6水平与vWF、D-二聚体呈正相关(r=0.319、0.372、0.661、0.558,P均<0.05),与ADAMTS-13呈负相关(r=-0.475、-0.553,P均<0.05)。结论慢阻肺稳定期患者存在明显炎症反应及血栓前状态,推测CRP、IL-6等炎症指标可能造成ADAMTS-13下降,从而加重血栓前状态,提示慢阻肺稳定期炎症反应是影响血栓前状态的重要因素。Objective To analyze the relationship between inflammatory response and prothrombotic state in patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 106 patients with stable COPD(COPD group)admitted to the hospital from April 2020 to April 2024,and 100 healthy individuals(healthy control group)who received health check-ups in the hospital during the same period were selected as the research subjects.The two groups were compared in terms of general information,pulmonary function[forced expiratory volume in one second(FEV_(1))and FEV_(1)%],inflammation indicators[C-reactive protein(CRP)and interleukin(IL-6)],prothrombotic state[von Willebrand factor(vWF),vWF-cleaving protease(ADAMTS-13)and D-dimer].Spearman linear correlation analysis was conducted to analyze the relationship between inflammatory response and prothrombotic state in patients with stable COPD.Results FEV_(1)and FEV_(1)%in the COPD group were significantly lower than those in the healthy control group(P<0.05).The levels of CRP and IL-6 in COPD group were significantly higher than those in the healthy control group(P<0.05).The levels of vWF and D-dimer were significantly higher,and the level of ADAMTS-13 was significantly lower in COPD group than in the healthy control group(P<0.05).Correlation analysis showed that the levels of CRP and IL-6 were positively correlated with vWF and D-dimer in patients with stable COPD(r=0.319,0.372-0661,0.558,both P<0.05),and negatively correlated with ADAMTS-13(r=-0.475,-0.553,both P<0.05).Conclusion There are obvious inflammatory response and pre-thrombotic state in patients with COPD in stable stage.It is speculated that CRP,IL-6 and other inflammatory indicators may cause the decrease of ADAMTS-13,thus aggravating the prothrombotic state,suggesting that the inflammatory response in COPD in stable stage is an important factor affecting the pre-thrombotic state.

关 键 词：慢性阻塞性肺疾病 稳定期 炎症反应 血栓前状态 肺功能 

分 类 号：R563[医药卫生—呼吸系统]