COPD并急性呼吸衰竭患者微循环及血流变指标的变化规律研究

Study on characteristic variability of microcirculation and hemorheology indexes in the patients with COPD complicated with acute respiratory failure

目的探讨COPD并急性呼吸衰竭患者微循环及血流变指标的变化规律。方法选取2011年3月～2013年3月在我院治疗的COPD并急性呼吸衰竭患者75例为观察组,另选择同期进行治疗的不伴有呼吸衰竭的COPD患者72例为对照组,测定两组患者的甲襞微循环、微循环指标及血流变指标。结果 (1)观察组患者的管襻畸形率、红细胞聚集及白微栓显著高于对照组,血液流速、毛细血管流速均低于对照组(P<0.05);(2)观察组患者的管襻形态积分、血液流态积分、襻周状态积分及总积分显著高于对照组(P<0.05);襻顶血管直径观察组为(13.25±1.24)μm,显著低于对照组的(16.78±2.27)μm(P<0.05);(3)观察组患者的红细胞聚集指数、血浆黏度、全血黏度、全血还原黏度均高于对照组(P<0.05)。结论 COPD并急性呼吸衰竭患者血流变指标较高,而微循环状态较差。

Objective To study the characteristic variability of microcirculation and hemorheology indexes in the patients with COPD complicated with acute respiratory failure. Methods 75 cases with COPD complicated with acute respiratory failure from March 2011 to March 2013 in our hospital were selected as the observation group,while 72 cases with COPD were selected as the control group at the same period of treatment.The indexes of nail micro circulation,microcirculation and hemorheology of two groups were measured. Results （1）The abnormal vascular rate,erythrocyte aggregation and white microembolus in the observation group were significantly higher than those in the control group,while the blood speed and blood speed of nailfold capillary vessel were lower than those in the control group（P 〈 0.05）.（2）The scores and total multiple scores of vascular shape,blood flow pattern and vascular surrounding states of the observation group were much higher than those of the control group（P 〈 0.05）; The blood vessel diameter of vascular top in the observation group[（13.25 ± 1.24）μ m] was significantly lower than that in the control group[（16.78± 2.27） μ m]（P 〈 0.05）.（3）The whole blood viscosity,plasma viscosity,whole blood restore viscosity and RBC aggregation in the observation group were significantly higher than those in the normal group（P 〈 0.05）. Conclusion The patients with COPD complicated with acute respiratory failure have higher hemorheology indexes and poor microcirculation status.