Mechanisms of pulmonary embolism and/or deep vein thrombosis secondary to chronic obstructive pulmonary disease exacerbation in elders

Abstract

Objective To explore the inflammatory mechanisms of pulmonary embolism (PTE) and/or deep venous thrombosis (DVT) in elders secondary to chronic obstructive pulmonary disease (COPD) exacerbation. Methods A total of 26 elders with acute exacerbation of high-risk COPD secondary PTE and/or DVT and 26 patients with low-risk COPD during stable phase diagnosed during the period of January 2008 to December 2012 were enrolled. The relevant parameters of routine blood examination, blood viscosity, D-dimer, fibrinogen (FIB), arterial blood gas, blood cytokine, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were retrospectively analyzed. Results The major nonspecific symptoms were cough, sputum and dyspnea. The mean of neutrophile percentage (N%), D-dimer, FIB, interleukin-6 (IL-6), tumor necrosis factor (TNF), C-reactive protein (CRP), low and high shear blood viscosity in blood samples of patients with acute exacerbation of high-risk COPD secondary PTE and (or) DVT were higher than those of the control group (t=3.339, 2.700, 2.207, 2.431, 2.257, 2.143, 2.223, 2.797, all P<0.05). However arterial partial pressure of oxygen (PaO2) was lower than that of lower-risk COPD patients (t=4.312, P<0.05). IL-6 in blood of patients with acute exacerbation of high-risk COPD secondary PTE and (or) DVT was positively correlated with low-shear blood viscosity, D-dimer and FIB (r=0.437, 0.624, 0.429, all P<0.05). TNF in blood of patients with acute exacerbation of high-risk COPD secondary PTE and (or) DVT was positively correlated to FIB, low and high cut blood viscosity (r=0.624, 0.519, 0.513, all P<0.05). Plasma CRP in blood of patients with acute exacerbation of high-risk COPD secondary PTE and/or DVT was positively correlated with D-dimer, FIB, IL-6 and TNF (r=0.478, 0.541, 0.533, 0.491, all P<0.05). Conclusions Inflammation may exist in elders with acute exacerbation of high-risk COPD secondary thrombotic disease. IL-6 and TNF may promote thrombosis secondary to acute exacerbation of COPD disease. Early screening and/or prophylactic anticoagulation are necessary for prevention. Key words: Pulmonary disease, chronic obstructive; Pulmonary embolism; Venous thrombosis