长期卧床患者凝血状况及血液流变学研究

The study of coagulation in patients with long-term bedridden status and blood rheology

目的探讨长期卧床患者凝血状况及预防血栓发生的措施。方法 采用酶联免疫吸附法定量测定86例患者在不同卧床期间的血液流变学和凝血谱指标,并与同地区健康人172例的血液标本进行比较,分析导致血管病发生的危险因素。结果长期卧床患者的血液流变学指标明显高于健康对照组,凝血谱与健康对照组比较差异亦有统计学意义(P<0.05,P<0.01),且全血黏度(ηb)、血浆黏度(ηp)、红细胞压积(Hct),纤维蛋白原(Fib)及D-二聚体水平与卧床时间呈正相关(r=0.385、r=0.368、r=0.392、r=0.425、r=0.417,P均<0.05),凝血酶原时间(PT)、活化凝血活酶时间(APTT)和凝血酶时间(TT)与卧床时间呈负相关(r=-0.383、r=-0.415、r=-0.451,P均<0.05)。结论长期卧床易产生血液微循环障碍,造成血液呈高黏滞性和高凝状态,使静脉血栓等血管病产生和加剧。

Objective To investigate the coagulation status of patients with long term of bed rest and prevention the rapy of thrombosis.Methods ELISA quantitative determination of blood rheology and coagulation spectral index of 86 patients in the different period of bed rest were tested and recorded,the disease risk factors were analyzed compared with 172 cases of healthy blood samples.Results Hemorheology index of bedridden patients was significantly higher than the healthy control group,the difference of coagulation spectrum between bedridden group and healthy control group was also significant（P 0.05,P 0.01 ）.The whole blood viscosity（ηb）,plasma viscosity（ηp）,hematocrit（Hct）,fibrinogen（Fib） and D-dimer levels were positively correlated with bed time（r =0.385,r =0.368,r =0.392,r =0.425,r =0.417,P 0.05,respectively）. Prothrombin time（PT）,activated thromboplastin enzyme time（APTT） and thrombin time（TT） were negatively cor related with time in bed（r = -0.383,r = -0.415,r = -0.451,P 0.05,respectively）.Conclusion Bedridden status prone to cause blood microcirculation dysfunction,lead to high viscosity and hypercoagulable state,therefore the venous thrombosis were more commonly occurred.