慢性阻塞性肺疾病凝血功能和血气分析相关性的研究

Correlative study between coagulation function and blood gas analysis in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)急性加重期凝血功能的变化及其与血气分析的相关性。方法检测97例COPD急性加重期患者治疗前(A组)和治疗后(B组)的凝血功能:凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FBG)及D-二聚体(D-D)、动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2),与健康体检者(C组)作比较,并分析动脉血气与凝血指标的相关性。结果 A组患者FBG及D-D显著高于B组和C组(P<0.01),B组患者FBG及D-D显著高于C组(P<0.01),而PT、APTT、TT差异无显著性(P>0.05);FBG与PaO2呈显著负相关,与PaCO2呈显著正相关,D-D与PaO2呈显著负相关,与PaCO2呈显著正相关。结论在COPD的发展过程中,存在高凝状态,监测FBG及D-D的变化,有助于了解患者疾病的严重程度,为适时采取有效的抗凝措施改善预后提供依据。

Objective To explore the correlation between coagulation function and blood gas analysis in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods 97 AECOPD patients were selected, and their plasma coagulation parameters were detected before and after the treatment, which included prothrombin time （ PT ）, partial thromboplastin time （APTT） , thrombin time （TT） , fibrinogeu （FBG） , D-dimer （D-D） and levels of PaO2 and PaCO2. Then the parameters were compared with the control group. The correlation between coagulation indexes and blood gas value was analyzed. Results The levels of FBG and D- D were the highest in the group A, followed by the group B and C （P 〈0. 01 ）. There was no significant difference on PT, APTT, TT among the three groups （ P 〉 0. 05 ）. FBG was negatively correlated with PaO2 , and positively correlated with PaCO2. D-D was negatively correlated with PaO2 , and positively correlated with PaCO2. Conclusion There exists hyper-eoagulation state in AECOPD patients. The monitoring of FBG and D-D may be helpful to control COPD progress and provide evidence for proper anti-coagulation therapy.