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Abstract：
BACKGROUND Platelets have important modulatory effects on inflammatory and immune-mediated pathways. Thrombocytopenia is a critical condition that is frequently encountered in the intensive care unit (ICU) and increases mortality. This retrospective study of 472 patients admitted to the ICU with acute exacerbation of chronic obstructive pulmonary disease (COPD) aimed to evaluate thrombocytopenia and mean platelet volume (MPV) with prognosis and patient mortality. MATERIAL AND METHODS A total of 472 patients diagnosed with COPD according to GOLD criteria and hospitalized in the tertiary ICU between 1 April 2018 and 11 May 2021 were included in the study. Platelets were calculated by the impetance method and MPV was simultaneously calculated based on the platelet histogram. Patients with platelet count ≤100×10⁹/L and >100×10⁹/L and patients with MPV values <7 fl, 7-11 fl, and >11fl were compared in terms of mortality and prognosis. RESULTS The mortality rate in COPD patients with thrombocytopenia was high, at 61.5%. Thrombocytopenia (P=.002), high MPV (P=.006) Acute Physiology and Chronic Health Evaluation-2 (APACHE-II) score (P=.025), length of stay (LOS) in the ICU (P=.009), mechanical ventilation duration (P<.001), leukocytosis (P<.001), high Sequential Organ Failure Assessment (SOFA) score (P<.001), LOS in the hospital (P=.035), and hypoalbuminemia (P<.001) were significantly associated with mortality. CONCLUSIONS Thrombocytopenia, high MPV, high APACHE-II and SOFA scores, LOS in the ICU and hospital, duration of mechanical ventilation, leukocytosis, and hypoalbuminemia predict mortality in COPD patients. Since infection-sepsis, hypoalbuminemia, and hypoxia can worsen this situation, ensuring early infection control, providing albumin support, and preventing hypoxia contribute significantly to reducing thrombocytopenia and mortality.
摘要：
背景技术血小板对炎症和免疫介导的途径具有重要的调节作用。血小板减少症是重症监护病房（ICU）中经常遇到的危重病，并增加死亡率。这项回顾性研究纳入了因慢性阻塞性肺疾病（COPD）急性加重而入住ICU的472例患者，旨在评估血小板减少症和平均血小板体积（MPV）与预后和患者死亡率的关系。材料与方法2018年4月1日至2021年5月11日，根据GOLD标准诊断为COPD并在三级ICU住院的472例患者纳入研究。血小板通过脉压法计算，MPV同时基于血小板直方图计算。血小板计数≤100×10/L和>100×10/L的患者和MPV值<7fl的患者，7-11fl,和>11fl在死亡率和预后方面进行了比较。结果COPD合并血小板减少患者死亡率高,61.5%。血小板减少症（P=0.002），高MPV（P=.006）急性生理学和慢性健康评估-2（APACHE-II）评分（P=.025），ICU住院时间（LOS）（P=.009），机械通气时间（P<.001），白细胞增多症（P<.001），高序贯器官衰竭评估（SOFA）评分（P<.001），在医院的LOS（P=.035），低蛋白血症(P<.001)与死亡率显著相关。结论血小板减少症，高MPV,高APACHE-II和SOFA分数，ICU和医院的LOS，机械通气的持续时间，白细胞增多,低白蛋白血症可预测COPD患者的死亡率。因为感染-败血症,低蛋白血症,缺氧会使这种情况恶化，确保早期感染控制，提供白蛋白支持,预防缺氧对降低血小板减少和死亡率有显著作用。
