The Expression And Significance Of Endothelin-1and Interleukin-8in The Patients With Chronic Obstructive Pulmonary Diseases Complicated Pulmonary Embolism

Objective To investigate the clinical characters of patients with chronicobstructive pulmonary disease （COPD） complicated pulmonary embolism （PE）.Discussion the effect between endothelial injury and inflammation from the researchof endothelin1and interleukin-8in the patients with COPD complicated PE.Methods42patients with acute excethation of COPD （AECOPD） and26patients with COPD complicated PE were seclected in First Affiliated Hospital ofHenan University of Science and Technology during February2010and August2011.All patients were removed from the study such as atherosclerosis, cerebral infarction,myocardial infarction and recent operation history due to having the risk of catchingvenous thrombus embolism （VTE）. The diagnosis of COPD was according to “thediagnosis and treatment guideline of COPD”. The diagnosis of PE was according to“the the diagnosis and treatment guideline of PE” and all patients with PE weremaking a definite diagnosis with CT pulmonary angiogram （CTPA）. Another30healthy persons were recruited as control group at the same period. Compare thedifference of symptoms and signs, arterial blood gas, coagulation function between thepatients with AECOPD and COPD complicated PE. Investigated the plasmaconcentration of interleukin-8（IL-8） and endothelin-1（ET-1） in the three grouops anddiscuss the relativity of the two cell factor using Elisa method. The SPSS17.0statistical software was used to statistical analysis.Results1. The comparison of clinical symptoms and signs between the patientswith AECOPD and COPD complicated PE.There has significant difference in the clinical symptoms and signs betweenCOPD+PE group, single COPD group and healthy control group （P＞0.05）. There has significant difference in hemoptysis, chest pain, pleural effusion, lungconsolidation,atelectasis, not equal between low limbs between COPD+PE group and single COPDgroup （P＜0.05）,but no significant difference was found in cough, sputum,dyspnea, syncope, right cardiac failure, S_IQ_IIIT_III（P＞0.05）.2. The comparison of arterial blood gas and coagulation function between thepatients with AECOPD and COPD complicated PE.The partial pressure of oxygen （PaO₂） in the arterial blood was decreasedObviously in the patients with with AECOPD and COPD complicated PE whencompared with healthy person. The partial pressure of carbon dioxide （PaCO₂） wasincreased significantly in the patients with COPD when compared with the patientswith COPD complicated PE and healthy person. However, there was no significantdifference in PaO₂and obvious increase in PaCO₂when compared the group of COPDwith the group of COPD complicated PE.The thrombin time （TT）, prothrombin time （PT）, level of fibrinogen （Fbg） andD-dimers were significant increased in the patients with COPD and COPDcomplicated PE when compared with healthy person. The PT was shortened obviouslyand level of Fbg was increased of COPD+PE group compared to COPD group.3. The determination of IL-8and ET-1in the group of COPD and the group ofCOPD+PE and study the relationship between the two cell factors. The Plasmaconcentration of IL-8in the patients with COPD and the patients with COPDcomplicated PE was significant increased when compared with healthy person （P<0.01）. The level of IL-8was significant increased in the COPD+PE group whencompared with the COPD group （P <0.05）.The plasma concentration of ET-1in the patients with COPD and the patientswith COPD complicated PE was significant increased when compared with healthyperson （P <0.01）. The level of ET-1was significant increased in the COPD+PE groupwhen compared with the COPD group （P <0.05）. The plasma concentration of IL-8were positively correlated with ET-1in the patients with COPD complicated PE（r=0.796，P <0.001）.Conclusion1. When there was no hemoptysis, chest pain, pleural effusion,lungconsolidation, atelectasis, not equal between low limbs in symptoms and signs, weshould be care PE maybe happened in COPD patients. 2. The coagulation function and fibrinolysis in COPD+PE group was more activethan COPD group.3. Inflammation and endothelial injury cause the occurrence of PE in COPDpatients and there were positively correlation between the two factors.