慢性阻塞性肺疾病急性加重期并发脑梗死患者血液流变学及血气分析

Hemorheology and blood gas analysis of COPD patients complicated by CI in acute exacerbation time

目的 观察慢性阻塞性肺疾病（COPD）急性加重期并发脑梗死患者血液流变学各项指标和血气的变化及两者之间的关系.方法 检测46例COPD急性加重期并脑梗死（CI）患者（合并症组）和44例COPD急性加重期患者（COPD组）血液流变学各项指标、纤维蛋白原（Fg）、D-二聚体（DD）及血气的变化,并与45例健康体检者（对照组）做比较.结果 与对照组相比,合并症组、COPD组的全血黏度、血浆黏度、红细胞比容、血小板黏附率、Fg和DD含量显著升高,差异有统计学意义（P〈0.05）;而合并症组全血黏度、Fg和DD含量也明显高于COPD组;Fg和DD与血PacO呈正相关（rFg=0.36,P〈0.01,rDD=0.510,P〈0.01）.结论COPD急性加重期并CI患者存在异常的凝血状态,改善通气及早期应用抗凝药物治疗,可能会减少COPD急性加重期合并CI的发生.

Objective To observe indicators of hemorheology and blood gas analysis of COPD（ chronic obstructive disease） patients complicated by CI（cerebral infarction） in acute exacerbation time and the relationship between them.Methods 46 patients with COPD complicated by CI in acute exacerbation time（complications group） and 44 patients with COPD in acute exacerbation time（COPD group） blood rheology indicators,fibrinogen（Fg） ,D-di-mer（DD） and blood gas analysis were detected.And 45 cases of health-related physical check （control group） were recruited for comparison.Results Compared with the control group,complication group,COPD group of whole blood viscosity,plasma viscosity,hematocrit,platelet adhesion rate,Fg,and DD levels were significantly increased,the difference was significant（P〈0.05） ;The complications group of whole blood viscosity,Fg,and DD levels were significantly higher than COPD group;Fg and DD and blood PaCO2 correlated（ r Fg =0.36,P〈0.01 ,rDD =0.510,P〈0.01）.Conclusion Patients with chronic obstructive pulmonary disease and cerebral infarction in acute exacerbation time had abnormal coagulation status,and improving ventilation and early application of anticoagulant drug therapy,could reduce the chronic obstructive pulmonary disease,the occurrence of cerebral infarction.