慢性阻塞性肺疾病合并不成比例肺动脉高压患者血浆D-二聚体水平测定及分析

Detection and significance of plasma D-dimer in chronic obstructive pulmonary disease with out of proportion in pulmonary hypertension

目的探讨慢性阻塞性肺疾病(COPD)合并不成比例肺动脉高压患者血液是否呈高凝状态。方法选择稳定期COPD合并肺动脉高压(PH)患者46例,其中COPD合并不成比例PH患者9例(A组),其余COPD合并PH患者37例(B组),具有可比条件的正常中老年人20例为正常对照组(C组),分别检测三组受检查血浆D-二聚体水平。结果 A组血浆D-二聚体水平显著高于B组(P<0.05),也显著高于C组(正常对照组)(P<0.05);B组血浆D-二聚体水平与C组无明显差异(P>0.05)。COPD合并不成比例PH组患者平均肺动脉压与血浆D-二聚体水平有显著相关性(r=0.86,P<0.01)。结论 COPD合并不成比例PH患者血液呈高凝状态,理论上可行抗凝治疗。

Objective To observe the content of D-dimer in chronic obstructive pulmonary disease （COPD） with out of proportion in pulmonary hypertension （ PH ）. To investigate the changes of coagulation function in these patients. Methods The content of D-dimer was examinated in 37 COPD with PH patients（ B group）, 9 COPD with out of proportion PH patients （A group） and 20 normal health people （ C group）. Results The content of D-dimer in A group was distenetly higher than that in B group and control group （ P 〈 0.05 ）. The content of D-dimer was not significantly different between B group and control group（ P 〉 0.05 ）. There was significant correlation between mean pulmonary arterial pressure and plasma D-dimer in COPD with out of proportion PH patients （ r = 0.86, P 〈 0.01 ）. Conclusion The blood of COPD with out of proportion in PH is in a hypercoagulatory state ,these patients potentially should be treated with anticoagulant drugs.