Abnormality Of Fibrinolysis System And Endothelin-1 In Patients With Chronic Obstructive Pulmonary Disease And The Relationship Of C-reactive Protein With Them

Objective:To investigate abnormality of fibrinolysis system,endothelin in patients with chronic obstructive pulmonary disease(COPD) and the relationship of C-reactive protein(CRP) with them.Methods:Conventional hematology inspection such as white blood cell from 121 patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) was detected.Among them,30 patients were selected as AECOPD group.When their illness alleviated,they were enrolled in COPD paracmasis group.20 healthy individuals were enrolled in control group.The plasma levels of CRP,tissue plasminogen activator(t-PA),plasminogen activator inhibitor-1(PAI-1) and endothelin-1(ET-1) were measured by enzyme-linked immunosorbent assay.90 cases of AECOPD underwent deep venous ultrasonography of both lower limbs.Spiral CT pulmonary angiography was further performed in the patients suspected as pulmonary thromboembolism.The K-W test and linear correlation analysis were completed by using SPSS 13.0.Results:In 121 patients with AECOPD,peripheral white blood cell count of 32 cases (26.4%) increased.In 90 patients examined by deep venous ultrasonography of both lower limbs,nine cases(10%) accompanied deep vein thrombosis,two cases(2.2%) accompanied pulmonary thromboembolism.Compared with control group,the levels of CRP and PAI-1 significantly increased,and t-PA significantly decreased in AECOPD group and COPD paracmasis group (all P<0.001).The level of ET-1 in AECOPD group was significantly higher than that in control group (P<0.001),but there was no significantly differences in COPD paracmasis group and control group(P>0.05).The levels of CRP,PAI-1 and ET-1 in AECOPD group were significantly higher than those in COPD paracmasis group (P<0.001),while t-PA was significantly lower in AECOPD group than that in COPD paracmasis group(P<0.001).CRP was positively correlated with PAI-1 and ET-1(r=0.871,0.675,P < 0.001) and was negatively correlated with t-PA(r=-0.587,P<0.001).Conclusions:AECOPD patients have abnormal fibrinolysis,high levels of CRP and ET-1.CRP maybe a predictor of prethrombolic state(PTS) in COPD patients or patients of COPD with vein thromboembolism(VTE).