Changes And Significances Of PGI2in Patients With COPD Combining PTE

Objective Chronic obstructive pulmonary disease (COPD) is a lung diseasecharacterized by airflow restriction, prevalence, high mortality, and chronicinflammation of COPD is a central link of thrombosis. Therefore it is considered thesecondary risk factors for PTE, and the mortality of COPD is elevated significantlyafter the merge PTE. This study aims to investigate changes of prostacyclin (PGI2) inCOPD, COPD merging PTE and discuss the possible diagnostic value and protectionmechanism.Methods According to the revised edition guideline of COPD2007of ChineseMedical Association,30patients with acute exacerbations of COPD (COPD group),26chronic obstructive pulmonary disease patients with acute pulmonary thrombo-embolism (COPD merging PTE group) were enrolled between December2010andDecember2011at the first affiliated hospital of Henan University of science andtechnology.30healthy persons were randomly choosen as a control group fromchecking up people in the same period at the same hospital. All of them were measuredbody height and weight, recorded smoking pack-years and lung function test,measured the levels of PGI2and D-D in blood plasma by enzyme-linkedimmunosorbent assay (ELISA). The data were expressed by mean and standarddeviation. One way analysis of variance was used to analyze the data of two groupsand further multiple comparisons were performed with LDS-q test meeting variancealign sexual test and performed with Dunnett’s T3test not meeting variance alignsexual test. The difference among these groups was analyzed by statistic methods.Furthermore, linear correlations were performed between PGI2and D-D, Pulmonaryfunction parameters FEV1/FVC of patients with COPD, patients with COPD mergingPTE respectively. All the data were processed by SPSS13.0and samples were testedby t-test with a=0.05as the standard, and it is of statistical significance when P<0.05. Results1. The level of Fbg in COPD group and COPD merging PTE group wassignificantly higher than those of control group, and the level of COPD merging PTEgroup was also obviously higher than the COPD group (P<0.001). Differences in thethree groups have statistically significant (P<0.01), and the differences of the twogroups also have statistical significance (P<0.05).2. The level of D-D in COPD group and COPD merging PTE group wassignificantly higher than those of control group, and the level of COPD merging PTEgroup was also obviously higher than the COPD group (P<0.001). Differences in thethree groups are statistically significant (P<0.01), and the differences of the twogroups also have statistical significance (P<0.05).3. The level of D-D in COPD group and COPD merging PTE group wassignificantly higher than those of control group, and the level of COPD merging PTEgroup was also obviously higher than the COPD group (P<0.001). Differences in thethree groups are statistically significant (P<0.01), and the differences of the twogroups also have statistical significance (P<0.05).4. The level of PGI2in COPD group and COPD merging PTE group wassignificantly lower than those of control group, and the level of COPD merging PTEgroup was also obviously lower than the COPD group (P<0.001). Differences in thethree groups are statistically significant (P<0.01), and the differences of the twogroups also have statistical significance (P<0.05).5. In COPD merging PTE group, through the contrast test between PGI2and d-dimer, Spearman correlation coefficients r=-0.549, P<0.01. There is a significantnegative correlation between the two groups. In acute exacerbations of COPD groups,Spearman correlation coefficients r=-0.429, P=0.018. There is a significant negativecorrelation.6. In COPD merging PTE group, through the contrast test between PGI2andFEV1/FVC, Spearman correlation coefficients r=-0.562, P<0.01. There is a significantpositive correlation between the two groups. In acute exacerbations of COPD groups,Spearman correlation coefficients r=-0.415, P=0.018. There is a significant positivecorrelation.Conclusion1. The level of Fbg and D-D in plasma in acute exacerbations of COPD wasobviously higher than normal control group. That indicated a hypercoagulable state in patients with acute exacerbations of COPD.2. The level of Fbg and D-D in plasma in acute exacerbations of COPD group andCOPD combined PTE groups was significantly higher. It suggested that Fbg and D-Dlevels in plasma can be used as a prediction reference indicators for COPD combinedPTE.3. Plasma levels of LDH in acute exacerbations of COPD groups and COPDcombined PTE groups were increased, probably due to myocardial cell injury inducedby inflammation and hypoxia, and it’s consistent with the past study.4. The level of PGI2in patients with acute exacerbations of COPD wassignificantly lower than the normal control group, because pulmonary vascularendothelial cell was injuried, then the ability of synthetizing PGI2reduced, whichconsistent with previous related study.5. Plasma level PGI2of patients with COPD combined PTE was significantlylower than acute exacerbations of COPD, which suggested level PGI2as a predictionfactor of COPD merging PTE.6. This study prompted that PGI2or PGI2analogue therapy may prevent PTE inpatients with COPD, and it is a new approach for COPD treatment.