Ramesh Prasanna Jeganathan, R (2010) Plasma Fibrinogen and Platelet Mass as Indicators of the Prothrombotic and Systemic Inflammatory State in COPD. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION : COPD is a disease of increasing public health importance around the world. GOLD estimates suggest that COPD will rise from the sixth to the third most common cause of death worldwide by 2020. Worldwide, COPD is the only leading cause of death that still has a rising mortality. Even though there have been significant advances in the understanding and management of COPD, the disease may be largely preventable, but it remains marginally treatable. It is well known that COPD is a syndrome of progressive airflow limitation caused chronic inflammation of the airways and lung parenchyma. But it also produces significant systemic consequences. The role of systemic inflammation as evidenced by the rise in inflammatory markers is now being increasingly recognised to play an important role in the systemic effects. The systemic effects include cachexia, skeletal muscle dysfunction, cardiovascular disease, osteoporosis, depression, fatigue among many others. It is also found that there is an ongoing hypercoagulable state in COPD. It is evidenced by the increased incidence of pulmonary thrombosis and coronary artery disease in these patients. The hypercoagulable state is being attributed to altered platelet functions and clotting system activation as has been shown by increased platelet size, high blood fibrinogen levels in patients with COPD. AIMS AND OBJECTIVES: The aims of the study were as follows; 1. To study the plasma fibrinogen level in patients with COPD. 2. To study the mean platelet volume in patients with COPD. 3. To study the correlation between plasma fibrinogen level and mean platelet volume and severity of COPD. MATERIALS AND METHODS: Study Design: Case Control Study . Period of Study: June 2008 To June 2009. Materials/Selection Of Study Subjects: Outpatients and Inpatients Visiting the Medical and Thoracic Medicine Department and On Healthy Volunteering Controls. Consent : Informed Consent Obtained from Cases and Controls. Conflict Of Interest : Nil. Financial Support: Nil. For Cases: Inclusion Criteria: 1. Male patients with Chronic obstructive pulmonary disease (FEV1/FVC <70%). 2. Ex- smokers (who has quit smoking for > 15 years). Exclusion Criteria: 1. Patients in Acute exacerbation, 2. Bronchial asthma (improvement of FEV1 by >15%after bronchodilator suggesting reversibility of airflow obstruction), 3. Restrictive lung diseases (FVC/FEV1 ≥ 70%; Predicted FEV1% < 80%), 4. Pulmonary tuberculosis, 5. Bronchiectasis, 6. Malignancies, 7. Acute infections, 8. Inflammatory disorders (eg.,Rheumatoid arthritis, glomerulonephritis), 9. Cardiac failure, 10. Acute Myocardial infarction , Acute stroke, 11. Significant trauma, 12. Patients refusing consent. SUMMARY: The study “Plasma Fibrinogen and Platelet Mass as Indicators of the Systemic Inflammatory and Prothrombotic state in COPD” was a case control study conducted on 75 COPD patients and 75 healthy controls in Govt. Rajaji Hospital, Madurai. Patients and controls who satisfied the inclusion criteria were included in the study and detailed history was elicited from them. They underwent investigations like, lung function tests, plasma fibrinogen, mean platelet volume, PaO2 measurements. COPD patients were found to have significantly elevated plasma fibrinogen and mean platelet volume. Plasma fibrinogen and mean platelet volume significantly correlated with severity of COPD. Also, they had significantly elevated ESR, leucocyte count and platelet count. Platelet count significantly correlated with the severity of COPD. Hence, it can be concluded that there is systemic inflammatory prothrombotic state in COPD. Also, the systemic inflammation increases with the severity of COPD. CONCLUSION: 1. There is an increased Fibrinogen level in patients with COPD. 2. There is an increased Mean Platelet Volume in patients with COPD. 3. Fibrinogen and Mean Platelet Volume increases as the severity of COPD increases. 4. There is also an increased leucocyte count, platelet count, ESR in patients with COPD. 5. This indicates that there is Systemic Inflammatory and Prothrombotic state in COPD. 6. Systemic Inflammation increases as the severity of COPD increases.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Plasma Fibrinogen ; Platelet Mass ; Indicators ; Prothrombotic ; Systemic Inflammatory State ; COPD. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Mar 2018 02:29 |
| Last Modified: | 16 Mar 2018 02:29 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6286 |
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