凝血和纤溶功能检测对判断慢性阻塞性肺疾病患者病情和并发症的价值

The Value of Blood Coagulation and Fibrinolysis in Judgment of Patients' s State and Complications in Chronic Obstructive Pulmonary Disease

目的探讨凝血和纤溶功能检测对判断慢性阻塞性肺疾病(COPD)患者病情和并发症的价值。方法随机选取我院COPD患者135例,其中稳定期85例(其中24例合并肺栓塞),急性加重期50例,另选取同期门诊体检的健康者50例为对照组,比较各组凝血酶原时间(PT)、部分活化的凝血活酶时间(aPTT)、组织型纤溶酶原激活物(t PA)、纤维蛋白原(Fbg)、D二聚体(D-D)的变化。结果急性发作期COPD组患者PT和aPTT明显延长,tPA、Fbg和D-D水平均明显高于稳定期COPD组和健康对照组(P<0.05);COPD患者中上述各项指标均明显高于对照组(P<0.05),其中24例COPD合并合并肺栓塞患者,血清Fbg和D-D水平明显高于单纯COPD稳定期组患者,而PT和a PTT延长,差异呈显著性(P<0.05)。结论 COPD患者凝血和纤溶功能异常,急性发作期患者常处于高凝低纤溶状态,而合并肺栓塞患者高凝状态更为明显。因此,检测凝血和纤溶指标有助于判断COPD病情和合并症有重要价值。

Objective To explore the blood coagulation and fibrinolysis to determine the clinical value of chronic obstructive pulmonary disease（COPD）patients＇ s state and complications. Methods 135 cases of COPD patients,including 85 cases in stable stage （24 cases with pulmonary embolism）, acute 50 cases in a- cute exacerbation stage were randomly selected from our hospital ,simultaneously ,50 healthy adults as control group were studied, Prothrombin time （ PT ）, activated clotting time （ aPTF ）, tissue plasminogen activator （ tPA）, fibrinogen （ Fbg）, D- dimer （ D- D） of the groups were measured and analyzed. Results The acute stage of COPD patients, PT and aFIT significantly were extended, tPA, Fbg and D-D levesl were significantly higher than that of stable COPD group and healthy control group （ P 〈 0. 05 ） ; The above- mentioned indexes in pa- tients with COPD were significantly higher than that of control group（P 〈0. 05 ） ,of which 24 cases of patients with COPD combined with pulmonary embolism, Fbg and D-D level obviously were higher than that of pure stable group of patients with COPD, and PT and aPTT were extended,has statistically significant difference（P 〈0. 05）. Conclusion COPD patients exist abnormal coagulation and fibrinolytic system, especially patients with acute stage are more easily in a hyper-coagulation and low fibrinolysis, and with pulmonary embolism are more apparent hypercoagulable state. Therefore,the detection of blood coagulation and fibrinolytic indexes has important value to determine the state of illness and complications.