Exploring The Correlation Between Small Airway Lesions And Coagulation Function In Asthma From The Pathogenesis Of "Stasis Blocking Lung Collaterals"

Objective: By observing the TCM syndromes and relevant laboratory indicators of patients with asthmatic small airway diseases,analyzing the correlation between asthmatic small airway diseases and coagulation related indicators(D-Dimer、PT.IRN、PT、PT-%、APTT、Fib、TT、PLT、MPV、PDW、PCT),exploring the correlation between coagulation related indexes and "blood stasis syndrome" in asthmatic small airway diseases based on the theory of "stasis blocking lung collaterals",and exploring the relationship between asthma small airway disease and blood stasis,treating asthma small airway disease from blood stasis,and improving the level of clinical diagnosis and treatment.Methods: A total of 122 asthmatic small airway lesions and 121 asthmatic small airway normal adult patients hospitalized in the Department of Pulmonology of the Affiliated Hospital of Shandong University of traditional Chinese medicine from December 2019 to December 2021 were selected.The age,gender,small airway indexes,coagulation related indexes,blood routine indexes TCM Syndrome Types and other data.The differences of the above indexes between small airway lesions and normal small airway were analyzed retrospectively;At the same time,the statistical difference of blood coagulation related indexes between each syndrome type and blood stasis distribution;To evaluate the risk factors of small airway lesions in asthma and the diagnostic value of coagulation related indexes,and draw a conclusion.Results: 1.There was no significant difference in age and gender between asthma small airway lesion group and small airway normal group(P>0.05).2.There was significant difference in small airway indexes and coagulation related indexes between the two groups(P<0.05).The levels of FEF50,FEF75 and MMEF75/25 indexes in asthma small airway disease group were significantly lower than those in asthma small airway normal group(P<0.01);The level of D-Dimer,Fib,APTT,PLT and PCT in small airway lesion group were higher than those in small airway normal group,and the difference was statistically significant(P<0.05).3.Asthmatic patients with small airway disease were divided into three groups according to different ages.There was a significant statistical difference in the determination of FEF50,FEF75,MMEF75/25,D-Dimer among the three different ages(P<0.05).4.In the correlation analysis between coagulation related indexes and small airway indexes,FEF50 had a very significant negative weak correlation with D-Dimer and Fib(P<0.01);FEF75 had a significant negative weak correlation with D-Dimer(P<0.05)and a very significant negative weak correlation with Fib(P<0.01);MMEF75/25 had a very significant negative weak correlation with D-Dimer and Fib(P<0.01).5.The variables D-Dimer,Fib,PLT and PCT are the possible risk factors for the occurrence of asthma small airway diseases.Fib are the independent risk factors for the occurrence of asthma small airway diseases.The areas under the curve of D-Dimer,APTT,Fib,PLT and PCT are 0.622、0.576、0.587、0.595 and 0.590,which has low diagnostic value for the diagnosis of asthma small airway diseases.6.In the distribution law of TCM Syndromes of asthmatic patients,the syndrome of phlegm heat obstructing the lung accounts for the largest proportion in 45 cases(36.9%),followed by phlegm turbidity obstructing the lung,wind phlegm obstructing the lung and lung qi deficiency,and there are certain changes in coagulation and other related indicators in the distribution of various syndrome types with blood stasis;In phlegm heat obstructing lung,D-Dimer,Fib and TT in the two groups were statistically significant(P<0.05);In phlegm turbidity obstructing lung,D-Dimer,Fib and TT had significant statistical difference(P<0.05);There was significant statistical difference in TT(P<0.05)between the two groups of patients in wind phlegm obstructing lung syndrome;There was significant statistical difference in PT-%and PLT between the two groups in lung qi deficiency(P < 0.05).Conclusion:1.There are obvious abnormalities in coagulation related indexes in patients with small airway disease of asthma,especially D-Dimer.Other indexes such as Fib,APTT,PLT and PCT also have certain changes,suggesting that there may be hypercoagulable state in the blood of patients with small airway disease of asthma,and there are abnormal changes in coagulation indexes in patients with asthma of different ages.2.Possible risk factors of asthma small airway disease: D-Dimer,Fib,PLT and PCT,among which Fib are independent risk factors of asthma small airway disease.3.D-Dimer and Fib as risk assessment indicators,have certain significance for the early diagnosis of small airway lesions in asthma.4.During the acute attack of asthma small airway disease,phlegm heat obstructing the lung,wind phlegm obstructing the lung and phlegm turbidity obstructing the lung are more common.Some patients can show the signs of concurrent blood stasis over time,and some syndrome types of concurrent blood stasis can have the changes of coagulation related indicators.