بررسي ارتباط شاخص هاي شمارش سلول هاي خوني با شدت بيماري انسدادي مزمن ريه در بيماران مراجعه كننده به بيمارستان كوثر سمنان

Relationship between complete blood count indices with the severity of disease in patients with chronic obstructive pulmonary disease

ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺑﯿﻤﺎري اﻧﺴﺪادي ﻣـﺰﻣﻦ ر ﯾـ ﻪ )Chronic obstructive pulmonary disease, COPD( ﯾﮑـ ﯽ از ﻋﻠـﻞ ﺷﺎﯾﻊ و روزاﻓﺰون ﻣﺮگ وﻣﯿﺮ و ﻧﺎﺗﻮاﻧﯽ ﺑﻪ ﺣﺴﺎب ﻣﯽ آﯾﺪ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻣﺎﻫﯿﺖ اﻟﺘﻬﺎﺑﯽ و ﻋﻮارض ﺷﻨﺎﺧﺘﻪ ﺷﺪه اﯾﻦ ﺑﯿﻤﺎري، در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ارﺗﺒﺎط ﺷﺎﺧﺺ ﻫﺎي ﺷﻤﺎرش ﺳﻠﻮل ﻫﺎي ﺧﻮﻧﯽ )Complete blood count, CBC ( ﺑﺎ ﺷﺪت COPD ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. ﻣﻮاد و روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ 48 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ COPD و 48 ﻓﺮد ﺳﺎﻟﻢ ﺗﺤﺖ اﺳﭙﯿﺮوﻣﺘﺮي ﺑﺎ و ﺑﺪون ﺑﺮوﻧﮑﻮدﯾﻼﺗﻮر ﻗﺮار ﮔﺮﻓﺘﻨﺪ. از ﮐﻠﯿﻪ ﺷﺮﮐﺖ ﮐﻨﻨﺪﮔﺎن ﻧﻤﻮﻧﻪ ﺧﻮن ﻧﺎﺷﺘﺎ ﺟﻬﺖ اﻧﺠﺎم CBC ﮔﺮﻓﺘﻪ ﺷﺪ و ﻧﺘـﺎ ﯾﺞ و اﻃﻼﻋـﺎت ﺗﮑﻤ ﯿﻠـ ﯽ در ﭘﺮﺳﺶ ﻧﺎﻣﻪ ﺛﺒﺖ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﯿﺰان WBC در ﮔﺮوه ﻣﺒﺘﻼﯾﺎن ﺑﻪ COPD ﺑﻪ ﺻﻮرت ﻣﻌﻨﯽ داري ﺑﺎﻻﺗﺮ از ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد )0/012=P(، اﻣﺎ در ﻣﺮاﺣﻞ ﺑﺎﻻي COPD ﻧﺴﺒﺖ ﺑﻪ ﻣﺮاﺣﻞ ﭘﺎﯾﯿﻦ ﺑﯿﻤﺎري ﻣﻌﻨﯽ دار ﻧﺒﻮد )0/449=P(. ﻣﻘﺎدﯾﺮ ﻣﻄﻠﻖ و ﻧﺴﺒﯽ ﻧﻮﺗﺮوﻓﯿﻞ ﻫـﺎ ﻧﯿـ ﺰ ﺑﻪ ﻃﻮر ﻣﻌﻨﯽ داري در ﻣﺒﺘﻼﯾﺎن COPD ﺑﺎﻻﺗﺮ از ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد )ﺑﻪ ﺗﺮﺗﯿﺐ 0/005=P و 0/035=P(. در ﻣﻘﺎﯾﺴـﻪ ﻣﺮاﺣـﻞ ﺑﺎﻻي COPD ﺑﺎ ﻣﺮاﺣﻞ ﭘﺎﯾﯿﻦ ﺑﯿﻤﺎري، اﯾﻦ ارﺗﺒﺎط ﺗﻨﻬﺎ در ﻣﻮرد ﺗﻌﺪاد ﻧﺴﺒﯽ ﻧﻮﺗﺮوﻓﯿﻞ ﻫـﺎ ﻣﻌﻨـ ﯽ دار ﮔﺮدﯾـ ﺪ )0/004=P(. ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ از ﻣﻄﺎﻟﻌﻪ ﻣﺎ اﺧﺘﻼف ﻣﻌﻨﯽ داري را ﺑﯿﻦ ﭘﺎراﻣﺘﺮﻫﺎي ﭘﻼﮐﺖ، ﻫﻤﻮﮔﻠﻮﺑﯿﻦ و ﺣﺠﻢ ﻣﺘﻮﺳﻂ ﭘﻼﮐﺘـ ﯽ )MPV( در ﮔﺮوه ﻣﻮرد و ﮐﻨﺘﺮل و ﻧﯿﺰ در ﻣﻘﺎﯾﺴﻪ ﻣﯿﺎن ﻣﺮاﺣﻞ COPD ﻧﺸﺎن ﻧﺪاد. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎﻻﺗﺮ ﺑﻮدن ﻣﻘﺎدﯾﺮ ﻣﻄﻠﻖ و ﻧﺴﺒﯽ ﻧﻮﺗﺮوﻓﯿﻞ و WBC ﻣﻄـﺎﺑﻖ ﺑـﺎ ﻣﺎﻫ ﯿـ ﺖ اﻟﺘﻬـﺎﺑ ﯽ اﯾـ ﻦ ﺑﯿﻤﺎري در ﮔﺮوه COPD دﯾﺪه ﺷﺪ. ﻋﻼوه ﺑﺮ اﯾﻦ ﻣﻘﺪار ﻧﺴﺒﯽ ﻧﻮﺗﺮوﻓﯿﻞ ﺑﺎ ﺷﺪت ﺑﯿﻤﺎري ارﺗﺒﺎط داﺷﺖ

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the common and increasing causes of mortality and morbidity. Considering the inflammatory nature and the known complications of this disease, in the present study the relationship between complete blood count (CBC) parameters and disease severity has been investigated. Materials and Methods: In the present study, 48 COPD patients and 48 healthy individuals underwent spirometry with or without bronchodilator. For CBC, fasting blood samples were obtained from all the participants. Results and supplementary information were recorded in questionnaires. Results: White blood cell (WBC) counts were significantly higher in COPD patients compared to the control group (P=0.012). However, there was no significant difference between low and high stages of the disease (P=0.449). Absolute and relative neutrophils counts were also significantly higher in COPD patients than the control group (P=0.005 and P=0.035, respectively). In high stages of COPD, relative neutrophils count was significantly higher compared to that of the low stages (P=0.004). Our results showed no significant differences in platelets, hemoglobin and mean platelet volume (MPV) between COPD patients and control group and also between the different stages of COPD. Conclusion: In the present study, we observed higher WBC and absolute and relative neutrophils counts in COPD patients compared to the control, which is consistent with the inflammatory nature of the disease. Furthermore, relative neutrophils count was related to COPD severity.