慢性阻塞性肺疾病急性期患者的凝血功能的变化

Analysison the Changes of the Coagulation Function Indicators of the Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的观察和分析慢性阻塞性肺疾病急性期(AECOPD)患者的凝血功能的变化。方法选取100例AECOPD患者作为病例组,选取100例健康志愿者作为对照组,对两组研究对象的凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、纤维蛋白原(Fbg)、凝血酶时间(TT)、D二聚体(D-D)及动脉血气指标、血常规指标、呼吸功能指标进行观察和比较。结果病例组患者的动脉血PH值、动脉血PaO_2、PLT、FEV1、FEV1%、FEV1/FVC水平均显著低于对照组,而动脉血PaCO_2、RBC、WBC水平均显著高于对照组,两组之间的差异均有统计学意义(P<0.05);病例组患者的Fbg水平显著高于对照组,而aPTT水平显著低于对照组,差异均有统计学意义(P<0.05);病例组患者的D-D水平显著高于对照组,差异均有统计学意义(P<0.05)。结论 AECOPD患者体内存在高凝状态和纤溶功能亢进,及时的监测与有效的干预可提高治疗效果、改善预后。

Objective To observe and analyze the changes of the coagulation function indicators of the patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods 100 cases of AECOPD patients were selected as the case group, 100 healthy volunteers were selected as the control group. The prothrombin time （ PT）, the activated partial thromboplastin time （ aPTT ）, the fibrinogen （ Fbg ）, the D- dimer（D-D） and the arterial blood gas indicators, the blood routine indicators, the respiratory function indicators of the objects in the two groups were observed and compared. Results The arterial blood pH value,the arterial blood PaO2 ,PLT, FEV1,FEV1% , FEVI/FVC levels of the patients in the case group were significantly lower than those in the control group, and the arterial blood PaCO2, RBC, WBC levels were significantly higher than those in the control group, the differences between the two groups were statistically significant（P 〈 0.05 ） ;The Fbg level of the patients in the case group was significantly higher than that in the control group, the aPTT level was significantly lower than that in the control group, the differences were statistically significant （ P 〈 0. 05 ） ; The D- D level of the patients in the case group was significantly higher than that in the control group, the difference was statistically significant （P 〈 0.05 ）. Conclusion The patients with AECOPD have significant hypercoagulable state and hyperfibrinolysis. The clinicians should the employ comprehensive and timely monitoring on the indicators of blood coagulation function and fibrinolysis and take timely and effective interventions so as to improve the therapeutic effects and improve the prognosis of the patients.