老年常见慢性病凝血功能的改变与临床意义

Changes of coagulation function in elderly patients with common chronic disease and its clinical significance

目的 探讨老年常见慢性疾病凝血机制和纤溶功能改变的临床意义.方法 对于2010年1月至2012年12月在复旦大学附属华东医院住院检查及治疗的86例老年患者,按原发性高血压、冠心病、慢性阻塞性肺疾病（CDPD）和/或慢性炎症、Ⅱ型糖尿病、血栓性疾病、恶性肿瘤等6种老年常见病分组,分别比较各组凝血功能及凝血因子方面的差异.结果 健康的老年人与患有常见病的老年患者相比,其凝血功能PT：（13.85±1.55）s、APTT：（37.38±6.41）s、活性度：（95.12±15.67）％、INR：（1.04±0.10）、FIB：（4.38±1.33） g/L、FDP：（0.49±0.94）、D-二聚体：（0.53±1.23）mg/L）两者差异均无统计学意义.但患有慢性阻塞性肺疾病、慢性炎症的老年患者其凝血因子Ⅴ（141.3±27.90）高于患有其他疾病的老年患者（P＜0.05）;患有冠心病的老年患者其凝血因子Ⅶ（117.77±14.17）高于其他疾病组;患有Ⅱ型糖尿病、血栓性疾病的老年患者凝血因子Ⅷ（171.21±14.90,172.64±8.44）高于其他疾病组（P＜0.05）;患有恶性肿瘤的老年患者FIB（6.00±1.29 g/L）水平高于其他疾病（P＜0.05）,差异均有统计学意义.结论 老年常见慢性疾病存在凝血功能异常.

Objective To analyse the changes and clinical significance of coagulation and fibrinolysis in elderly patients with common chronic diseases. Methods The changes of coagulation factors and coagulation function were analyzed in 86 elderly patients with hypertension, coronary heart disease, chronic obstructive pulmonary disease/chronic inflammation, type Ⅱ diabetes, thrombotic deseases and mailgnant tumor in the Huadong Hospital from 2010.1 to 2012.2. Results There was no significant differenceincoagulationfuction PT： （13.85±1.55）s, APTT： （37.38±6.4）is, INR： （1.04±0.099）, FIB： （4.38±1.33） g/L, activity： （95.12±15.67） %, FDP： （4.38±1.33） g/L, D-two dimer： （0.53±1.23） mg/L） between the healthy subjects and the elderly patients with common chronic disease. Meanwhile, coagulation factor Ⅴ levels （141.3±27.90） inelderly patients with chronic obstructive pulmonary disease/chronic inflammation werehigher thanthat in patients with other diseases （P 〈 0.05）. Coagulation factor Ⅶ levels （ 117.77 ± 14.17 ） in patients with coronary heart disease were higher than that in the healthy subjects （P〈 0.05）. Coagulation factor Ⅷ levels（ 171.21 ± 14.90,172.64 ±8.44 ） in patients with type Ⅱ diabetes/thrombotic disease were higher than that in patients with other diseases （P〈0.05）. The elderly patients with malignant tumor had a higher level of FIB （6.00±1.29） g/L as compared to those without malignant tumor （P〈0.05）. Therefore, therewas significant difierencebetween them. Conclusion The elderly patients with common chronic diseases had abnomal coagulation function.