慢性阻塞性肺疾病患者凝血状态临床观察

Clinical observation of blood coagulation state of patients with chronic obstructive pulmonary disease

目的观察慢性阻塞性肺疾病患者凝血状态的改变及其与病情的关系。方法比较自2014年1月1日~2014年12月31日1年间我院收治的COPD急性加重患者与同年龄健康人群凝血四项及D-二聚体（dimeride,D-Ⅱ）等指标的差异。观察AECOPD患者以上指标与肺功能分级、CAT分组及血气分析结果之间的关系。结果与健康对照组比较,AECOPD组APTT、PT及TT均显著缩短,FBG及D-Ⅱ均增高,差异具有显著性（P均〈0.05）。随着肺功能分级增加、CAT评分增加及血气分析变差,凝血及纤溶指标异常越明显（P均〈0.05）。结论 COPD患者尤其是急性加重期存在血栓前状态特点,凝血功能异常与病情严重程度相关。

Objective To observe the correlation of blood coagulation and disease condition of patients with chronic obstructive pulmonary disease （chronic obstructive pulmonary disease, COPD）. Methods Differences in four projects of blood coagulation including active partial prothrombin time （APTT）, prothrombin time （PT）, thrombin time （TT） and fibrinogen （FBG）, dimeride （D- Ⅱ ） and other indexes of patients with COPD acute exacerbation （（COPD acute exacerbation,AECOPD）who were admitted to our hospital from January 1st 2014 to December 31st 2012 and same- aged healthy people were compared. Relationship between above indexes and pulmonary function classification, CAT grouping and qi-blood analysis results of AECOPD patients was observed. Results In the AECOPD group, APTT, PT and TT were significantly reduced, FBG and D- Ⅱ were significantly increased when compared with the healthy control group（P 〈 0.05）. With the increasing of pulmonary function grade, CAT score and worsening of qi- blood analysis, abnormality of blood coagulation and fibrinolysis index was more significant（P 〈 0.05）. Conclusion COPD patients, especially AECOPD patients have pre-thrombotic state. Abnormality of blood coagulation is related to severity of the disease.