背景:最近,人们越来越有兴趣找到一个简单的,低成本,慢性阻塞性肺疾病(COPD)预后预测因子的广泛可用的生物标志物。
方法:绝对未成熟血小板计数(AIPC),AIPC占总血小板计数(未成熟血小板分数[IPF%])的百分比,症状,肺活量测定结果,年龄-呼吸困难-气流阻塞指数,记录COPD患者和对照组的C反应蛋白检测结果。中性粒细胞/淋巴细胞,单核细胞/淋巴细胞,计算血小板/淋巴细胞比率和Charlson合并症指数评分。
结果:本研究纳入了一百三十四名COPD患者和30名健康对照受试者。89例患者处于急性加重期(AECOPD),其中45例处于稳定期。COPD组和对照组的IPF%值和AIPC之间存在差异(3.45±2.41vs.2.04±1.12,p=0.01;5.87±2.45vs.5.20±3.02,p=0.01)。IPF%与白细胞计数和中性粒细胞/淋巴细胞比值呈正相关,血小板/淋巴细胞比率,所有患者的单核细胞/淋巴细胞比率(r=0.352,p<0.001;r=0.399,p<0.001;r=0.186,p=0.032;r=0.200,p=0.021)和AECOPD(r=0.356,p<0.001;r=0.414,p<0.001;r=0.239,p=0.025;r=0.273,p=0.010)。在临界值为3.4时,IPF%在识别COPD方面表现出最高的准确性(敏感性:80.3%,特异性:82.5%)使用接受者操作特性分析。
结论:这是第一个检查AIPC之间关系的研究,IPF%,和COPD。COPD患者IPF%值较高,IPF%与其他炎症指标呈正相关,提示IPF可能是COPD全身性炎症的指标。
BACKGROUND: Recently, there has been an increasing interest to find a simple, low cost, widely available biomarker for outcome predictors in chronic obstructive pulmonary disease (COPD).
METHODS: Absolute immature platelet count (AIPC), the percentage of AIPC to the total platelet count (immature platelet fraction [IPF%]), symptoms, spirometry results, age-dyspne-airflow obstruction index, and C-reactive protein tests of COPD patients and control group were recorded. Neutrophil/lymphocyte, monocyte/lymphocyte, and platelet/lymphocyte ratios and Charlson comorbidity index scores were calculated.
RESULTS: One hundred and thirty-four COPD patients and 30 healthy control subjects were included in the study. Eighty-nine patients were in exacerbation (AECOPD) and 45 of them were in stable COPD period. There was a difference between IPF% values and AIPC of COPD group and control group (3.45 ± 2.41 vs. 2.04 ± 1.12, p = 0.01; 5.87 ± 2.45 vs. 5.20 ± 3.02, p = 0.01). A positive correlation was observed between IPF% with white blood cell count and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio in all patients (r = 0.352, p < 0.001; r = 0.399, p < 0.001; r = 0.186, p = 0.032; r = 0.200, p = 0.021) and AECOPD (r = 0.356, p < 0.001; r = 0.414, p < 0.001; r = 0.239, p = 0.025; r = 0.273, p = 0.010). At a cut-off of 3.4, IPF% showed the highest accuracy in identifying COPD (sensitivity: 80.3%, specificity: 82.5%) using receiver-operating characteristic analysis.
CONCLUSIONS: This is the first study to examine the relationship between AIPC, IPF%, and COPD. The higher IPF% values in COPD and the positive correlation between IPF% and other inflammatory markers are suggested that IPF may be an indicator of systemic inflammation in COPD.