Studies On Platelet Parameters And Hepatic Function Changes Of COPD Patients With Syndrome Of Kidney Deficiency And Stagnation Of Phlegm

Objective: To investigate the distribution of COPD with syndrome of kidney deficiency and stagnation of phlegm (KDSP) and the clinical significance of platelet parameters and hepatic function changes. Methods: 103 patients of AECOPD belonging to SeverityⅢ～Ⅳwere divided into two groups, KDSP group and non- KDSP group, according to the differentiation of symptoms and signs for classification of syndrome. Five platelet parameters of COPD patients, including PLT, PDW, P-LCR, PCT and MPV were detected by automatic cytoanalyze; six serum biochemical indicators of COPD patients, including TBIL, GPT, ALP, TP, ALB and GLB were detected by automatic biochemistry analyzer. Results: 1. Among 103 AECOPD patients observed, there were 70 cases in KDSP group, taking a percentage of 68%; and 33 cases in non-KSPD group (including 8 cases with obstruction of the lung by phlegm, 10 cases with pulmonary retention of phlegmopyrexia, 3 cases with mental confusion caused by phlegm, 7 cases with syndrome of water over-flowing due to YANG-insufficiency, 5 cases with insufficiency of QI of the lung and kidney), taking 32%. There was no statistical significance between KDSP group and non-KDSP group about gender (P>0.05); and compared with non-KDSP group, the patients in KDSP group were elder, the difference of which had statistical significance (P<0.05). 2. Compared with the control group, the PLT levels of KDSP group and non-KDSP group both significantly decreased (P<0.01, P<0.05), and the decreased level of KDSP group was more significant. The PDW levels of KDSP group and non-KDSP group both significantly increased (P<0.01, P<0.01), and the increased level of KDSP group was more significant. The PCT levels of KDSP group and non-KDSP group both significantly decreased (P<0.01, P<0.05). The P-LCR level of KDSP group significantly increased (P<0.05), while the P-LCR level of non-KDSP group also increased, but had no statistical significance (P>0.05). There was no significant difference among the groups, the control group, KDSP group and non-KDSP group about the levels of MPV (P>0.05). 3. Compared with the control group, the TBIL level of KDSP group significantly increased (P<0.01), while the TBIL level of non-KDSP group also increased, but had no statistical significance (P>0.05); the ALT levels of KDSP group and non-KDSP group both significantly increased (P<0.01, P<0.05), while the ALT level of KDSP group increased more significantly; the ALB levels of KDSP group and non-KDSP group both significantly decreased (P<0.01, P<0.05), while the ALB level of KDSP group decreased more significantly. There was no statistical significance among the groups, the control group, KDSP group and non-KDSP group about the levels of ALP, TP and GLB. Conclusion: 1. KDSP is possibly one of the main patterns of syndrome of AECOPD belonging to SeverityⅢ～Ⅳin Xinjiang, and the elder people are susceptible to COPD with syndrome of KDSP.2. AECOPD patients belonging to SeverityⅢ～Ⅳappear platelet parameters abnormality, and AECOPD patients with syndrome of KDSP appear more significantly. Thus, AECOPD patients belonging to SeverityⅢ～Ⅳ, especially AECOPD patients with syndrome of KDSP are probably susceptible to appearing platelet aggregation; and they probably have the tendency of supervening thromboembolic disease. 3. Dynamic observation of platelet parameters changes of COPD patients possibly conduces to early diagnosis of COPD with thromboembolic disease. Early intervention prevents the aggravation of COPD. 4. AECOPD patients belonging to SeverityⅢ～Ⅳpresent hepatic function abnormality, and AECOPD patients with syndrome of KDSP appear more obviously. It is suggested that active symptomatic treatment and close attention to hepatic function changes of AECOPD patients belonging to SeverityⅢ～Ⅳ, especially AECOPD patients with syndrome of KDSP should be emphasized, in order to guiding the clinical rational administration and treatment to AECOPD. More researches are approaching.