慢性阻塞性肺疾病患者血浆ADAMTS-13变化及其与血栓前状态关系

发布时间：2018-11-19 22:18

【摘要】：【目的】探讨慢性阻塞性肺疾病(COPD)患者血管性血友病因子裂解酶(ADAMTS-13)水平及其与COPD血栓前状态、炎症反应的关系。【方法】采用酶联免疫吸附法(ELISA)测定67例在我院呼吸内科门诊及住院COPD患者(其中40例AECOPD,27例稳定期COPD)、21例健康对照者(11例吸烟健康者,10例非吸烟健康者)入组当天外周血血管性血友病因子(vWF)和ADAMTS-13水平,白介素6(IL-6)水平及血栓前状态的各指标(D-二聚体、纤维蛋白原)。【结果】AECOPD组、稳定期COPD组、吸烟健康组及非吸烟健康组血浆vWF水平分别为(12.5±1.9)、(9.8±1.5)、(5.5±1.9)及(3.8±1.3)pg/mL,呈依次下降趋势,协方差分析示各组间差异有统计学意义(P0.001);血浆ADAMTS-13水平分别为(261±59)、(396±74)、(668±138)及(913±131)ng/mL,呈依次上升趋势,协方差分析示各组间差异有统计学意义(P0.001)。多重线性回归分析显示血浆ADAMTS-13与血浆vWF(偏相关系数-0.661,P0.001)、D-二聚体(偏相关系数-0.357,P=0.028)、纤维蛋白原(偏相关系数-0.402,P=0.004)及IL-6(偏相关系数-0.275,P=0.001)均呈负相关。【结论】COPD患者血浆ADAMTS-13水平下降,全身炎症反应和吸烟可能是其原因之一,血浆ADAMTS-13水平下降或许是COPD患者血栓前状态形成的机制之一。
[Abstract]:[objective] to investigate the level of von Willebrand factor lyase (ADAMTS-13) in patients with chronic obstructive pulmonary disease (COPD) and its prethrombotic status with COPD. [methods] the relationship of inflammatory reaction. [methods] 67 patients with COPD were measured by enzyme-linked immunosorbent assay (Elisa) in our hospital, including 40 cases of AECOPD,27, 21 cases of stable COPD), 21 cases of healthy controls (11 cases of smoking healthy people). The levels of (vWF) and ADAMTS-13, interleukin-6 (IL-6) and prethrombotic status (D-dimer, fibrinogen) in peripheral blood of 10 non-smoking healthy persons were measured on the same day. [results] AECOPD group, The plasma vWF levels in stable COPD group, smoking healthy group and non-smoking healthy group were (12.5 卤1.9), (9.8 卤1.5), (5.5 卤1.9) and (3.8 卤1.3) pg/mL, respectively. Covariance analysis showed that there were significant differences among the groups (P0.001). The levels of plasma ADAMTS-13 were (261 卤59), (, 396 卤74), (, 668 卤138) and (913 卤131) ng/mL, respectively. Multiple linear regression analysis showed that plasma ADAMTS-13 had positive correlation with plasma vWF (-0.661g / P0.001), D-dimer (-0.357), fibrinogen (-0.402), and fibrinogen (-0.402). There was a negative correlation between P0. 004) and IL-6 (partial correlation coefficient-0. 275 P0. 001). [conclusion] the level of plasma ADAMTS-13 in COPD patients decreased. Systemic inflammation and smoking may be one of the causes. The decrease of plasma ADAMTS-13 level may be one of the mechanisms of prethrombotic state formation in COPD patients.
【作者单位】：中山大学附属第一医院内科重症监护室;中山大学附属第一医院肾内科;
【基金】：广东省自然科学基金(S2013010015025) 国家呼吸重点专科资助
【分类号】：R563.9

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