Comparison of relevant indicators of coagulation and fibrinolysis in patients with varying severity of community-acquired pneumonia

Abstract

To compare the relevant indicators of coagulation and fibrinolysis in patients with varying severity of community-acquired pneumonia (CAP). A total of 107 CAP hospitalized patients at Department of Respiratory Medicine, Affiliated Hospital, Chengde Medical College from July 2013 to June 2014 were enrolled as pneumonia group while another 52 healthy outpatients served as control group. The levels of routine blood test, coagulation function, procalcitonin and C-reactive protein (CRP) were measured and compared among different groups. All hospitalized CAP patients were divided into low and high-risk groups according to pneumonia severity index (PSI). And all indicators were measured to examine the differences among different groups. The white blood cell count in pneumonia group was significantly higher than that in control group ((9.3 ± 5.1) vs (7.5 ± 2.9) × 10(9)/L, P < 0.05). The red blood cell count, hemoglobin and platelet count in pneumonia group were significantly lower than those in control group ((4.3 ± 0.6) vs (4.8 ± 0.5) × 10(12)/L, (131.1 ± 18.7) vs (144.9 ± 17.4) g/L, (199.3 ± 69.4) vs (237.9 ± 72.5) × 10(9)/L, all P < 0.05). The D-dimer, fibrinogen degradation products (FDPs), fibrinogen (FIB), activated partial thromboplastin time (APTT) and prothrombin time (PT) in pneumonia group were significantly higher than those in control group ((1.86 ± 1.28) vs (0.48 ± 0.38) mg/L, (6.42 ± 3.27) vs (2.17 ± 1.46) mg/L, (3.87 ± 1.17) vs (3.42 ± 0.96) g/L, (35.64 ± 8.34) vs (31.29 ± 11.19) s, (12.21 ± 1.40) vs (11.36 ± 2.19) s, all P < 0.05) while thromboplastin time (TT) was lower than that in control group ((13.43 ± 3.38) vs (16.16 ± 2.89) s, P < 0.05). The levels of D-dimer, FDPs, procalcitonin, CRP, APTT and PT in high-risk group were significantly higher than those in low-risk group ((2.94 ± 1.14) vs (1.16 ± 0.78) mg/L, (8.85 ± 2.82) vs (4.85 ± 2.49) mg/L, (1.72 ± 1.16) vs (0.40 ± 0.51) µg/L, (104.2 ± 61.9) vs (67.4 ± 59.5) mg/L, (38.80 ± 8.41) vs (33.60 ± 7.69) s, (12.64 ± 1.76) vs (11.94 ± 1.03) s, all P < 0.05) while platelet count and TT were lower than those in low-risk group ((172.8 ± 57.1) vs (216.5 ± 71.6) × 10(9)/L, (12.10 ± 2.66) vs (14.28 ± 3.53) s, all P < 0.05). The abnormal rates of procalcitonin, D-dimer and FDPs in high-risk group were significantly higher than those in low-risk group (100% (42/42) vs 86.2% (56/65), 95.2% (40/42) vs 75.4% (49/65), 95.2% (37/42) vs 44.6% (29/65), all P < 0.05). The plasma levels of D-dimer, FDPs, procalcitonin and CRP were well-correlated with index of pneumonia severity (r = 0.636, 0.608, 0.629, 0.250, all P < 0.05). And the plasma level of platelet was negatively correlated with index of pneumonia severity (r = -0.320, P < 0.01). The red blood cell, hemoglobin and platelets are lower in patients with pneumonia than those in normal subjects. And the patients with pneumonia have coagulation and fibrinolysis disorders. The plasma levels of D-dimer, FDPs, procalcitonin, CRP and platelets are well-correlated with severity of CAP.