The Role of Ⅷ Factor and Von Willebrand Factor in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Deep Venous Thrombosis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

DuanShengchen ¹ ,  YangYuanhua ² , MiYuhong ¹

1. Department of EICU, Beijing An-Zhen Hospital, Capital Medical University, Beijing, 100029, China;
2. ;

Corresponding author：

YangYuanhua, Email: yyh1031@163.com

Keywords：

Chronic obstructive pulmonary disease; Acute exacerbation; Deep venous thrombosis; Ⅷ factor; Von Willebrand factor

DOI：

10.7507/1671-6205.2014134

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Objective To investigate the prevalence and risk factors of deep venous thrombosis (DVT) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods One hundred and eight patients with acute exacerbation of COPD admitted between March 2009 and September 2010 were consecutively included.On admission,color Doppler ultrasound examination of lower extremities was performed for diagnosing DVT in all cases.The patients with DVT were compared with those without DVT in demographics,symptoms,physical signs,risk factors and laboratory examination including Ⅷ factor and von Willebrand factor (VWF). Results Among 108 patients with acute exacerbation of COPD,DVT was detected in 11 cases (10.1%).In the COPD patients with DVT,the duration of hospitalization was longer (P<0.001) and the mechanical ventilation requirement increased (P=0.024) compared those without DVT.Other indicators for more possibility of DVT were immobility over 3 days (P=0.001),pneumonia as concomitance (P=0.004),type Ⅱ respiratory failure (P=0.011),and current smoking (P=0.002).The plasma leukocytes,D-dimer and Ⅷ factor levels were significantly higher in the COPD patients with DVT than those without DVT (P=0.005;P<0.001;P=0.009). Conclusion The incidence of DVT in patients with acute exacerbation of COPD is 10.1%.The prevalence of DVT is higher in distal extremities than that in proximal,especially the intermuscular veins.The patients with acute exacerbation of COPD have a higher risk of DVT when immobilized over 3 days,complicated by pneumonia or type Ⅱ respiratory failure,and having a high levels of plasma leukocytes,D-dimer and Ⅷ factor.

Citation： DuanShengchen, YangYuanhua, MiYuhong. The Role of Ⅷ Factor and Von Willebrand Factor in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Deep Venous Thrombosis. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(6): 546-549. doi: 10.7507/1671-6205.2014134 Copy

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1. 漆波,张鹤,李国智,等.慢性阻塞性肺疾病急性加重患者住院死亡影响因素研究.中国呼吸与危重监护杂志,2003,2:24-28.
2. 王辰,杜敏捷,曹大德,等.慢性肺心病急性发作期肺小动脉血栓形成的病理观察.中华医学杂志,1997,7:123.
3. Global strategy for the diagnosis,management,and prevention of COPD.Global Initiative for Chronic Obstructive Lung Disease(GOLD),2010. http://goldcopd.org/.
4. Groenewegen KH,Schols AM,Wouters EF.Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD.Chest,2003,124:459-467.
5. Akgun M,Metal M,Onbas O,et al.Comparison of clinical characteristics and outcomes of patients with COPD exacerbation with or without venous thromboembolism.Respiration,2006,73:428-433.
6. Hansson PO,Eriksson H,Welin L,et al.Smoking and abdominal obesity:risk factors for venous thromboembolism among middle-aged men:the Study of Men Born in 1913.Arch Intern Med,1999,159:1886-1890.
7. Kyrle PA,Minar E,Hirschl M,et al.High plasma levels of factor Ⅷ and the risk of recurrent venous thromboembolism.N Eng J Med,2000,343:457-462.
8. Undas A,Jankowski M,Kaczmarek P,et al.Thrombin generation in chronic obstructive pulmonary disease:dependence on plasma factor composition.Thrombosis Res,2011,128:e24-e28.
9. Koster T,Blann AD,Brie E,et al.Role of clotting factor Ⅷ in effect of von Willebrand factor on occurrence of deep-vein thrombosis.Lancet,1995,345:152-155.
10. Jenkins PV,Rawley O,Smith OP,et al.Elevated factor Ⅷ levels and risk of venous thrombosis.Br J Haematol,2012,157:653-663.
11. Tsai AW,Cushman M,Rosamond WD,et al.Coagulation factors,inflammation markers,and venous thromboembolism:the longitudinal investigation of thromboembolism etiology (LITE).Am J Med,2002,113:636-642.
12. 李立宇,王辰,庞宝森,等.慢性阻塞性肺疾病急性期凝血纤溶系统功能变化的临床研究.中国实用内科学杂志,2008,28:667-669.
13. Danl M,Tybjaerg-Hansen A,Vestbo J,et al.Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease.Am J Respir Crit Care Med,2001,15,164:1008-1011.

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The Role of Ⅷ Factor and Von Willebrand Factor in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Deep Venous Thrombosis

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