慢性阻塞性肺疾病急性加重期凝血指标分析

Analysis of coagulation indexes in acute exacerbation of chronic obstructive pulmonary disease

目的:检测慢性阻塞性肺疾病(COPD)患者在急性加重期血浆D-二聚体(D-D)、凝血酶-抗凝血酶复合物(TAT)、纤溶酶-抗纤溶酶复合物(PAP)含量。方法:试验组25例COPD急性加重期患者和对照组20例急性缓解期患者,抽取静脉血测定凝血酶原时间、部分凝血活酶时间、凝血酶时间、血小板计、DD、TAT、PAP7项指标。结果:慢性阻塞性肺疾病急性加重期患者血浆中D-D、TAT、PAP3项血清指标定量检测明显高于COPD缓解期患者,差异有统计学意义(P<0.01)。结论:COPD患者在急性加重期处于高凝状态,易并发血栓形成及弥散性血管内凝血,是导致本病死亡的主要原因之一。联合检测D-D、TAT、PAP3项血清标记物对诊断COPD急性加重期患者有一定的指导意义,并有可能为COPD急性加重期治疗过程中抗凝剂的应用提供依据。

Objective：To detect D-Dimer（DD）, thrombin-antithrombin complex（TAT ）,plasmimantiplasmin complex（PAP） in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） in order to find their clinical significance in the early diagnosis, treatment and prognosis of COPD. Method：25 COPD patients in acute exacer bation were selected as study group. 20 COPD patients in acute remission were selected as control group. The plasma prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, platelet count, DD, TAT and PAP of Both groups were deteced. Result： Serum levels of D-D,TAT , PAP of COPD patients in acute exacerbation were significantly higher than those in COPD patients in acute remission（ P〈0.01）. Conclusion：Combined detection of DD, TAT and PAP would had certain guiding significance for early diagnosis of COPD acute exacerbation and provide the basis for anticoagulant application in COPD acute exacerbation.