Background Hypoxic pulmonary hypertension (HPH) is a severe condition associated with vascular remodeling, right ventricular hypertrophy, and elevated pulmonary arterial pressure, particularly at high altitudes. Shengxian decoction (SXT), a classical Traditional Chinese Medicine (TCM) formula, has historically been used to treat pectoral qi deficiency syndromes related to cardiopulmonary dysfunction. However, its therapeutic mechanisms in HPH remain unclear. Methods A multi-omics approach integrating transcriptomics and metabolomics was employed to investigate the effects of SXT in an HPH animal model. Pulmonary artery smooth muscle cells (PASMCs) were exposed to hypoxic conditions in both in vivo and in vitro models. The therapeutic effects of SXT were evaluated using hemodynamic measurements, histopathological analysis, immunohistochemistry, RT-qPCR, Western blotting, flow cytometry, and EdU proliferation assays. Key signaling pathways were further validated using LOX-1 overexpression and knockdown models. Results SXT treatment significantly reduced mean pulmonary arterial pressure, right ventricular hypertrophy, and pulmonary vascular remodeling in HPH rats. Multi-omics analyses identified the LOX-1/P47phox/SRC/NF-κB signaling pathway as a key regulatory target. In vitro experiments demonstrated that SXT inhibited PASMCs proliferation and promoted apoptosis by regulating the LOX-1/P47phox/SRC/NF-κB signaling pathways. These effects were further confirmed in gene silencing and gene overexpression experiments. Conclusions SXT exerts protective effects against HPH by inhibiting the LOX-1/P47phox/SRC/NF-κB signaling pathway, thereby attenuating hypoxia-induced vascular remodeling. These findings provide mechanistic insight into the therapeutic potential of SXT and supports its modernization and clinical application in the treatment of HPH based on TCM theory.

Pulmonary Hypertension (PH) is a pathophysiological disease characterized by abnormally elevated pulmonary artery pressures due to a variety of known or unknown causes, which may ultimately lead to right ventricle (RV) failure or even death. The rat has become a major animal model of PH study because of its low cost, genetic control, and similarity of pathologic features to humans. The assessment of right heart function is crucial for basic research on PH and the diagnosis/treatment of PH diseases. Ultrasound imaging has become one of the main methods for assessing right heart function because of its noninvasive measurement, its ability to dynamically monitor the morphology and function of the rat heart, and its low cost and ease of use. Moreover, the new ultrasound technology of speckle tracking is able to detect myocardial dysfunction earlier and more sensitively, and three-dimensional ultrasound generates three-dimensional images of the heart, which is able to more accurately assess the morphology and functional changes of the right heart. In addition, correlation analysis of ultrasound indexes with the gold standard found that pulmonary acceleration time (PAT), PAT/pulmonary ejection time (PET) measured by ultrasound with pulmonary artery systolic pressure (PASP) measured by right heart catheterization (RHC); PAT measured by ultrasound with mean pulmonary artery pressure (mPAP) by RHC; and right ventricular free wall thickness (RVFWT) measured by ultrasound with Fulton’s index, showed good correlation. In this paper, we reviewed the pathologic changes of the heart in PH, the modeling methods of PH rat model, ultrasound imaging for the assessment of right heart function and the advantages of speckle tracking and three-dimensional ultrasound as emerging ultrasound technologies. And we also proposed that the multimodal fusion of ultrasound and cardiac magnetic resonance (CMR), micro computed tomography (micro-CT), artificial intelligence (AI) could be the future direction of cardiac function assessment in PH rat. Accurate assessment of right ventricular function is crucial for further research into the molecular mechanisms of PH and drug screening.

BackgroundThis study examined the relationship of patients' sex, age, body mass index, history of hypertension, various lipid indices, atherogenic index of plasma, bilirubin-lipid composite index 1, and bilirubin-lipid composite index 2 with the degree of coronary artery stenosis. The study aim was to identify factors associated with coronary stenosis and provide new perspectives for the diagnosis and treatment of coronary artery disease.MethodsA total of 175 patients who visited Qinghai Affiliated Hospital and underwent their first coronary angiography examination were included. Basic demographic information and laboratory measurements were collected. The atherogenic index of plasma and two bilirubin-lipid composite indices were calculated using biochemical indicators, and a correlation analysis of these data with post-imaging Gensini scores was performed using statistical analysis.ResultsTotal bilirubin, triglycerides, high-density lipoprotein, atherogenic index of plasma, and both bilirubin-lipid composite indices showed statistically significant differences between the observation and control groups. Binary multivariate logistic regression showed that the atherogenic index of plasma and both bilirubin-lipid composite indices had statistically significant and independent positive effects on coronary heart disease risk. Single-factor Spearman linear regression indicated that the atherogenic index of plasma and both bilirubin-lipid composite indices were positively correlated with the Gensini score, while total bilirubin was negatively correlated with the Gensini score. Receiver operating characteristic curve analysis showed a diagnostic specificity of 83.7% and sensitivity of 57.9% for coronary heart disease.ConclusionsHigher values of the atherogenic index of plasma and both bilirubin-lipid composite indices were associated with an increased risk of coronary heart disease and showed an independent positive correlation with the severity of coronary stenosis. Serum total bilirubin decreased with increasing severity of coronary stenosis, demonstrating an independent negative correlation. The diagnostic value of coronary heart disease was higher when the atherogenic index of plasma was >0.06, bilirubin-lipid composite index 1 was >1.89, or bilirubin-lipid composite index 2 was <3.69.Trial registration: Retrospectively registered.

Background: Continuous light exposure increases sympathetic excitation in rats, leading to hypertension, left ventricular hypertrophy, and fibrosis. This study was aimed to investigate whether continuous light exposure causes destabilization of vital signs and gut microbiota (GM) in Sprague Dawley (SD) rats and whether clonidine hydrochloride (CH), a central sympathetic depressant drug, could prevent these changes. Methods: Eight-week-old male SD rats were divided into three groups with different interventions for 14 weeks: control group (CG), 2-mL pure water gavaged daily while on a normal 12-h light/dark cycle; continuous illumination group (CI), 2-mL pure water gavaged daily while receiving continuous exposure to light (300 lx); and drug administration group (DA), CH (10 μg/kg) gavaged daily while receiving continuous exposure to light (300 lx). Results: The results showed that blood pressure, heart rate, and body weight were significantly higher in the CI group than in the CG and DA groups (P < 0.05). Moreover, the Shannon index was higher in the DA group than in the CI group (P = 0.012). The beta diversity index in the CG group was significantly higher in the CI group (P = 0.039). The pairwise comparison results of the linear discriminant analysis effect size showed that Oscillospirales were enriched in the DA group, whereas the Prevotellaceae lineage (family level) > Prevotella (genus level) > Prevotellaceae_bacterium (species level) were enriched in the CI group. The Muribaculaceae family was more abundant in the CG group than in the CI group. Conclusion: Sympathetic nerve inhibition restored the abnormal vital signs and GM changes under continuous light exposure.

In cardiac electrophysiology, it is commonly suggested that in the patients with non-STelevation myocardial infarction（NSTEMI） the culprit vessel has not developed total occlusion. however, in the clinical practice, the results of coronary angiography in some patients with NSTEMI diagnosed by electrocardiography indicate the presence of total occluded coronary artery（TOCA）. At present, there are no treatment recommendations for NSTEMI patients with TOCA in China, which leads to prolonged occlusion of TOCA vessels and prolonged myocardial injury, thus leading to an delayed resolution of the quality of life of NSTEMI patients combined with TOCA, which is visible in their significantly poorer long-term prognosis. The paper reviews the progress of research on the epidemiology, mechanisms and etiology, risk prognosis and risk factors of NSTEMI patients with TOCA.

目的 分析中、高海拔地区高血压患者其肠道菌群是否存在各自特征性的分布,探究是否可以肠道菌群为靶点进行预防、治疗高血压.方法 分别收集世居于中海拔地区(1500～2500 m)及高海拔地区(2500～4500 m)的高血压患者粪便样本各20例,中、高海拔地区健康者粪便样本分别为21、20例,四组分别为:中海拔地区高血压患者组、中海拔地区健康者组、高海拔地区高血压患组、高海拔地区健康者组.提取样本DNA,利用16S rRNA高通量测序技术,研究肠道菌群分布特点.使用SPSS 26.0统计软件及生物信息学数据分析方法进行统计分析.探讨中、高海拔地区高血压患者肠道菌群结构是否存在其各自的特点及差异.结果 与MA-HTN相比,HA-HTN组肠道高表达Akkermansia、Catenibacterium、Slackia和Senegalimassilia(P<0.05);与HA-HTN相比,MA-HTN组肠道高表达Candidatus_Saccharibacteria、Clostridium_ⅩⅧ和Lachnospiracea_incertae_sedis(P<0.05).结论 HA-HTN高丰度的Akkermansia可能通过抗炎和免疫刺激特性以及改善肠道屏障功能、胰岛素敏感性和内毒素血症对该地区的高血压患者存在一定的保护作用.MA-HTN肠道中高表达Candidatus_Saccharibacteria以及位置未定的Lachnospiracea_ncertae_sedis可能与该地区高血压患者饮食习惯有关,或许对该地区高血压患者是保护性因素.

BACKGROUND:The pathological mechanism of chronic thromboembolic pulmonary hypertension (CTEPH) is not fully understood, and inflammation has been reported to be one of its etiological factors. IgG regulates systemic inflammatory homeostasis, primarily through its N-glycans. Little is known about IgG N-glycosylation in CTEPH. We aimed to map the IgG N-glycome of CTEPH to provide new insights into its pathogenesis and discover novel markers and therapies.METHODS:We characterized the plasma IgG N-glycome of patients with CTEPH in a discovery cohort and validated our results in an independent validation cohort using matrix-assisted laser desorption/ionization time of flight mass spectrometry. Thereafter, we correlated IgG N-glycans with clinical parameters and circulating inflammatory cytokines in patients with CTEPH. Furthermore, we determined IgG N-glycan quantitative trait loci in CTEPH to reveal partial mechanisms underlying glycan changes.RESULTS:Decreased IgG galactosylation representing a proinflammatory phenotype was found in CTEPH. The distribution of IgG galactosylation showed a strong association with NT-proBNP (N-terminal pro-B-type natriuretic peptide) in CTEPH. In line with the glycomic findings, IgG pro-/anti-inflammatory N-glycans correlated well with a series of inflammatory markers and gene loci that have been reported to be involved in the regulation of these glycans or inflammatory immune responses.CONCLUSIONS:This is the first study to reveal the full signature of the IgG N-glycome of a proinflammatory phenotype and the genes involved in its regulation in CTEPH. Plasma IgG galactosylation may be useful for evaluating the inflammatory state in patients with CTEPH; however, this requires further validation. This study improves our understanding of the mechanisms underlying CTEPH inflammation from the perspective of glycomics.

目的:分析心房颤动病人血清miR-296-3p变化,探究miR-296-3p的潜在靶基因,探讨miR-296-3p在心房颤动发生机制中的作用.方法:选取2020年6月—2021年6月于我院心内科住院治疗的心房颤动病人50例作为心房颤动组,选取同期于我院体检中心进行体检的健康志愿者15名作为健康对照组.检测两组血清miR-296-3p的表达水平.通过分析临床资料及相关生化指标,探究血清miR-296-3p表达水平与之的相关性.采用TargetScan预测miR-296-3p的潜在靶基因.采用实时荧光定量法(qRT-PCR)和蛋白质印迹法(Western Blot)检测miR-296-3p mimic抑制SCN5A的效果.结果:心房颤动组病人血清miR-296-3p水平明显高于对照组(P<0.01).阵发性心房颤动组、持续性心房颤动组及永久性心房颤动组病人血清miR-296-3p表达水平具有明显差异,且随着心房颤动时间的延长,miR-296-3p的表达水平增加(P<0.05).心房颤动病人血清miR-296-3p表达水平与左房内径呈正相关(r=0.422,P=0.030).不同浓度的miR-296-3p可直接靶向作用于SCN5A的3'-UTR区域.不同浓度的miR-296-3p mimic可结合SCN5A的3'-UTR进而抑制SCN5A的mRNA和蛋白表达水平.结论:心房颤动病人血清miR-296-3p的表达水平上调,与病人的左房内径呈正相关,miR-296-3p可负调控SCN5A的表达参与心房颤动病人的心房重构.

With the deepening understanding of hypertension,more and more evidence suggests that the blood pres-sure levels of hypertensive patients are closely related to sodium salts.The gut microbiome is made up of bacteria,ar-chaea,fungi,protozoa and viruses,also known as the gut microbiome,intestinal flora and its metabolites,as a hot re-search direction in hypertension,play an important role in the relationship between sodium and blood pressure.Excessive sodium salt can change the type and proportion of intestinal microbiota,affect the level of inflammation and metabolism of the body and accelerate the occurrence and development of hypertension.Sodium control is a low-cost and effective way to control blood pressure.This article reviews the complex relationship between sodium salts,gut microbiota,and hyperten-sion,hoping to provide theoretical support for the prevention,treatment,and control of hypertension.

目的 探究藏药十八味诃子利尿散对2型糖尿病模型大鼠心肌的保护作用.方法 将40只雄性SD大鼠适应性饲养72 h后随机分成两组:对照组(CG,10只)、造模组(BMG,30只),分别用等量普通饲料、高脂饲料喂养.12 w后,在BMG大鼠尾静脉注射STZ(25 mg/kg),在CG大鼠尾静脉注射等剂量柠檬酸钠无菌缓冲液.第3、7天时取尾静脉血测定尾静脉空腹血糖(fasting blood glu-cose,FBG).视第7天随机FBG水平≥16.7 mmol/L为糖尿病大鼠造模成功.继续用原饲料喂养5 w,将造模成功的大鼠随机分为模型组(MG,10只)、藏药组(TMG,10只).分组后灌胃,TMG组的灌胃物为十八味诃子利尿散(300 mg/kg),CG、MG组予以等剂量生理盐水,持续2 w.麻醉后处死大鼠,留取心肌组织,使用HE染色法观察大鼠心肌组织及胰腺组织,用IHC染色法定位晚期糖基化终产物受体(receptor of advanced glycation end products,RAGE)、核因子 κB(nuclear factor-κB,NF-κB)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumornecrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β),用 Western Blot 法测定 RAGE、NF-κB、IL-6、TNF-α、IL-1β 等蛋白的表达水平.结果 与CG组相比,MG组的胰腺腺泡细胞排列紊乱,细胞核着色不清,少数细胞核固缩,胰岛稀少;心肌纤维着色不均,部分心肌纤维变性坏死,坏死肌纤维胞质溶解呈淡染或空网状,胞核崩解.TMG组胰腺组织无明显减轻,心肌结构病变微小.IL-6、TNF-α、IL-1β、NF-κB(p65)主要分布在细胞质及细胞间质;RAGE主要分布在细胞核、细胞质及细胞间质.与MG组相比,TMG组的心肌损伤减轻;IL-6、NF-κB、RAGE、TNF-α蛋白表达水平显著降低(P＜0.05),IL-1β 蛋白表达无明显差异(P＞0.05).结论 十八味诃子利尿散对糖尿病大鼠心肌具有一定的保护作用,可能是通过RAGE/NF-κB信号转导途径抑制炎症而改善糖尿病心肌病(diabetic cardiomyopathy,DCM).

目的:探讨冠心病患者肠道菌群与血尿酸、冠脉粥样硬化程度的关系.方法:收集我院心内科检查治疗的冠心病患者30例(病例组)和体检中心健康体检者30例(对照组)资料.根据血尿酸水平、Genesini积分分组,应用实时荧光定量PCR检测肠道菌群.结果:病例组和对照组血尿酸含量比较,差异有统计学意义(P＜0.05).不同血尿酸病例组患者粪便菌落相对拷贝数比较:Ⅳ组和对照组比较,大肠杆菌、幽门螺旋杆菌差异均有统计学意义(P＜0.05);Ⅲ组和对照组、Ⅰ组比较,大肠杆菌差异有统计学意义(P＜0.05);Ⅲ组与对照组比较,幽门螺杆菌差异有统计学意义(P＜0.05);各组间比较,乳酸杆菌、双歧杆菌差异均无统计学意义(P＞0.05).不同Genesini积分病例组患者粪便菌落相对拷贝数比较:Ⅳ组与对照组比较,幽门螺杆菌差异有统计学意义(P＜0.05);与Ⅱ组、Ⅲ组比较,幽门螺杆菌差异有统计学意义(P＜0.05),Ⅲ组与对照组比较,幽门螺杆菌差异有统计学意义(P＜0.05);各组间比较,乳酸杆菌、大肠杆菌、双歧杆菌差异均无统计学意义(P＞0.05).结论:冠心病患者肠道菌群紊乱,与冠脉血管病变程度的加重和尿酸水平的升高呈正相关.

Objective To analyze the distribution and composition of intestinal flora in Tibetan patients with coronary artery heart disease (CHD) on the Qinghai-Tibet Plateau. Methods From September 2018 to September 2020, following patients were recruited: Tibetan CHD patients living in the area of Qinghai-TibetPlateau [altitude 3600-4500 m, Tibetan patients at high altitudes with CHD (HTC)], healthy people [(normal Tibetans at high altitudes(HTN)], Han patients with CHD living in Xining [altitude 2260 m, Han CHD at a middle altitude (MHC)] and Wuhan [altitude 13 m, Han CHD at a low altitude(LHC)], for a long time. Among them, HTC and MHC were all from inpatients of the Department of Cardiology, Affiliated Hospital of Qinghai University. HTN were all from the Physical Examination Center of the Affiliated Hospital of Qinghai University, and LHC were all from inpatients of the Department of Cardiology, the Union Hospital Affiliated to Huazhong University of Science and Technology. The fecal samples were collected, and the 16S rRNA V3-V4 regions of the intestinal flora were DNA sequenced and bioinformatic analysis was performed. Results A total of 36 CHD patients (8 HTC, 14 MHC, 14 LHC) and 34 HTN patients that met the inclusion and exclusion criteria were enrolled. α-diversity analysis showed that there was no significant difference in the Shannon index of intestinal flora between HTC and HTN (P=0.091), the Shannon index of intestinal flora in HTC was the highest, followed by MHC, and the lowest in LHC(P=0.025). β-diversity analysis showed that the intestinal flora distribution of HTC was significantly different from that of HTN, MHC and LHC. In the analysis of the composition of intestinal flora, HTC also showed different characteristics from MHC and LHC at the phylum level and genus water. The relative abundance of its pathogenic bacteria, i.e. Streptococcus, Escherichia_Shigella and Klebsiella decreased; the beneficial bacteria, i.e. Faecalibacterium, Prevotella, Catenibacterium and Lactobacillus, were increased in relative abundance. Conclusions The intestinal flora of high-altitude Tibetan patients with CHD showed polymorphisms that were different from those of healthy Tibetans at the same altitude and CHD patients at medium and low altitudes.

研究表明,肠道菌群参与了高血压的发生、发展过程,关于其机制的研究目前包括代谢产物对血压的影响、微生物群-肠道-大脑轴及免疫因素、血管内皮损伤等方面,其中肠道菌群代谢产物(包括短链脂肪酸、胆汁酸、脂肪酸等)与高血压的关系研究较为充分.本文主要综述了肠道菌群代谢产物与高血压的关系,以期为高血压的预防和治疗提供理论基础和新的治疗思路.

主动脉瘤指各种病因导致主动脉扩张或膨出并达到正常管径的1.5倍以上,多数患者无明显症状,仅少数患者出现不典型症状,极易漏诊.主动脉瘤致急性心肌梗死的症状与左主干病变致急性心肌梗死相似,二者极易混淆.本文报道了1例以胸痛为首发症状的主动脉瘤致急性心肌梗死患者,以期为临床诊疗提供参考.

目的探讨急性冠状动脉综合征(ACS)患者血清微小RNA(miR)-133a、miR-208a的表达水平及与冠状动脉病变程度的关系.方法选取2017年2月至2019年2月青海大学附属医院收治的ACS患者120例,冠状动脉轻度病变(SYNTAX评分≤22分)34例、中度病变(SYNTAX评分23-31分)51例、重度病变(SYNTAX评分≥32分)35例,冠状动脉造影为单支病变29例、双支病变35例、3支病变32例、多支病变24例.选取本院同期收治的稳定型心绞痛(SAP)患者60例(SAP组)和体检健康者60名(健康对照组).比较3组研究对象的基线资料,血清miR-133a和miR-208a水平,不同冠状动脉病变严重程度和病变支数组ACS患者血清miR-133a和miR-208a水平,分析ACS患者血清miR-133a和miR-208a水平与SYNTAX评分、冠状动脉病变支数的相关性,以及血清miR-133a和miR-208a对ACS患者冠状动脉中重度病变的诊断价值.结果 ACS组和SAP组血清miR-133a和miR-208a水平均高于健康对照组[(2.49 ±0.72)、(1.50±0.61)比(1.06±0.58),(0.64±0.15)、(0.32 ±0.11)比(0.21 ±0.16)],且ACS 组均高于SAP组(均P<0.05).随着冠状动脉病变程度的加重和冠状动脉病变支数的增加,ACS患者血清miR-133a和miR-208a水平呈逐渐升高趋势(均P<0.05).ACS患者血清miR-133a和miR-208a与SYNTAX评分均呈正相关(r= 0.637、0.702,均P<0.05),与冠状动脉病变支数均呈正相关(rs = 0.653、0.691,均P<0.05).血清miR-133a与miR-208a联合诊断ACS患者冠状动脉中重度病变的曲线下面积高于血清miR-133a 和miR-208a 单独检测(0.872比0.816、0.805).结论血清miR-133a 和miR-208a 在ACS 患者中表达上调,并与冠状动脉病变程度密切相关,早期联合检测可作为临床辅助评估ACS病情严重性的生化指标.

微小核糖核酸(miRNA)是一类高度保守的短链非编码RNA,对心血管具有重要的调控作用,与心脏发育和再生、心脏肥大等都有关系.心房颤动是临床最常见的心律失常之一,严重影响患者的生活质量.研究表明,miRNA与心房颤动有关,miRNA通过参与心房结构重构,导致心肌纤维化;通过参与心房电重构,使心房动作电位时程及不应期缩短、心房传导速度减慢,导致心律失常的发生.

目的 观察中海拔地区不同暴露时间下大鼠肝脏组织脂肪酸代谢相关指标的变化.方法 SPF级SD雄性大鼠60只,根据饲养环境不同分为对照组、1 d组、3 d组、7 d组、15 d组、30 d组各10只,对照组在西安交通大学医学部动物实验中心动物房(海拔400 m)饲养30 d;1 d组、3 d组、7 d组、15 d组、30 d组分别在青海大学医学院高原医学中心动物房(海拔2260 m)饲养1、3、7、15、30 d.检测各组血浆丙氨酸转氨酶(ALT)、游离脂肪酸(NEFA)及肝脏组织中的酮体(KB);检测肝脏组织中的AMP依赖的蛋白激酶(AMPK)、乙酰辅酶A羧化酶1(ACC-1)、肉碱棕榈酰基转移酶1(CPT-1)和低氧诱导因子1α(HIF-1α)mRNA及蛋白.结果 各组血浆ALT、NE-FA及肝脏组织中KB水平差异均无统计学意义.对照组肝脏组织中AMPK mRNA表达量高于1 d组、3 d组、7 d组、15 d组和30 d组(P均<0.05).15 d组ACC-1、CPT-1 mRNA表达量最低,30 d组ACC-1、CPT-1 mRNA表达量升高至对照组水平;1 d组、3 d组、7 d组、15 d组HIF-1αmRNA表达量高于对照组,30 d组降低至对照组水平.对照组与1 d组AMPK蛋白表达高于3 d组、7 d组、15 d组、30 d组(P均<0.05);3 d组ACC-1、CPT-1、HIF-1α蛋白表达量高于对照组、1 d组、7 d组、15 d组、30 d组(P均<0.05).结论 中海拔地区与平原地区暴露的大鼠脂肪酸代谢存在差异.中海拔地区急性暴露期大鼠脂肪酸合成与氧化代谢呈现一过性增强,至暴露第7天,随着缺氧迅速改善,又恢复到平原地区水平.

短链脂肪酸(SCFA)可以预防及治疗冠心病的危险因素、抑制其发病机制及改善预后.可以通过补充SCFA或者增加膳食纤维、移植产SCFA的肠道菌群、适量减少盐的摄入以及服用一些中药来增加体内的SC-FA含量,防治冠心病.本文综述了SCFA在冠心病的危险因素、发病机制以及并发症中的研究进展,以期为SC-FA在冠心病防治中作用提供理论依据.

目的:探究高海拔地区慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)合并继发性红细胞增多患者的炎症和凝血水平,为改善患者预后及提高患者生存质量提供依据.方法:选取2016年1月至2019年9月青海大学附属医院的222例COPD患者,其中合并继发性红细胞增多的111例患者作为病例组,另外非合并继发性红细胞增多的111例患者作为对照组,回顾性收集患者住院期间的凝血相关指标、红细胞沉降率、C反应蛋白和红细胞参数,对两组患者的相应指标进行对比分析,并对COPD合并继发性红细胞增多患者的炎症和凝血指标进行相关性分析.结果:COPD合并继发性红细胞增多患者的凝血酶原时间延长且高于对照组水平,差异有统计学意义(P<0.05);对照组D-二聚体水平、红细胞沉降率、C反应蛋白和纤维蛋白原含量较病例组高,纤维蛋白原含量与红细胞沉降率和C反应蛋白呈正相关,红细胞压积与红细胞沉降率呈负相关,差异有统计学意义(P<0.05).结论:应警惕高海拔地区COPD合并继发性红细胞增多患者由于凝血机制发生改变而导致的出血风险,关注患者的炎症相关指标变化,及早合理地对这类患者的炎症及凝血水平进行干预,以改善患者预后.