慢性阻塞性肺疾病急性加重期患者血气分析与凝血功能相关性研究

Study of correlation between blood gas and coagulation function in patients with chronic obstructive pulmonary disease in acute exacerbation period

目的研究慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者血气分析与凝血功能的相关性。方法选取本院收治的AECOPD患者32例作为A组,COPD稳定期患者25例作为B组,另选取同期本院体检的健康26例作为C组,检测所有研究对象活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)、D-二聚体(D-D)、氧分压(PaO2)及二氧化碳分压(PaCO2)水平,并分析凝血相关指标及动脉血气相关指标的相关性。结果三组研究对象APTT、TT及PT比较差异均无显著性(P均>0.05),而Fbg、D-D、PaO2及PaCO2水平比较差异均有显著性,A组患者Fbg、D-D及PaCO2水平均显著高于其他两组(P<0.05),PaO2水平显著低于其他两组(P<0.05)。直线相关分析结果表明,A组患者Fbg与PaO2呈负相关(r=-0.213,P<0.05),与PaCO2呈正相关(r=0.264,P<0.05);A组患者D-D与PaO2呈负相关(r=-0.315,P<0.05),与PaCO2呈正相关(r=0.376,P<0.05)。结论 AECOPD患者存在血液高凝状态,对D-D及凝血功能相关指标的监测有助于预防和控制疾病的发展。

Objective To study the correlation between blood gas and coagulation function in patients with chronic obstructive pulmonary disease in acute exacerbation period. Method 32 patients with chronic obstructive pulmonary disease in acute exacerbation period as group A, 25 patients with chronic obstructive pulmonary disease in stable period as group B, 26 healthy subjects as group C were chose and received activated partial thromboplastin time （APTT）, thrombin time （TT）, prothrombin time （PT）, fibrinogen （Fbg）, D-dimer, PaO2 and PaCO2 detection. Result The APTT, TT and PT value of the three groups had no significant difference （P 〉 0.05）, and the Fbg, D-D, PaO2 and PaCO2 value had significant difference （P 〈 0.05）. The Fbg, D-D and PaCO2 value of group A were significantly higher than that of group B and C （P 〈 0.05）, and PaO2 value of group A was significantly lower than that of group B and C （P 〈 0.05）. Fbg and D-D were negatively correlated with PaO2 value in group A; Fbg and D-D were positively correlated with PaCO2 value in group A. Conclusion Patients with chronic obstructive pulmonary disease in acute exacerbation period hypercoagnlable state. The monitor of D-D and coagulation index will be useful in the prevention of the disease development.