慢性阻塞性肺疾病急性期患者凝血功能变化

Study on the changes of coagulation function of patients with acute exacerbation of chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病急性期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者凝血功能的变化与意义。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(FIB)、凝血酶时间(TT)、D-二聚体(two D-dimer,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p H值、动脉血氧分压(Pa O2)、血小板计数(PLT)、一秒用力呼气容积(FEV1)、一秒用力呼气容积与用力肺活量的比值(一秒率,FEV1%)水平均显著低于对照组,而动脉血二氧化碳分压(Pa CO2)、红细胞(RBC)、白细胞(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(均P<0.05);病例组患者的FIB和D-D水平均显著高于对照组,而APTT水平显著低于对照组,差异均有统计学意义(均P<0.05)。结论:AECOPD患者体内存在着显著的高凝状态和纤溶功能亢进,临床医生应及时采取有效的干预措施,从而提高疗效、改善患者的预后。

Objective To discuss the changes and significance of coagulation function of patients with acute exacerbation ofchronic obstructive pulmonary disease（ AECOPD）. Methods： 100 cases of patients with AECOPD were selected as the case group,and100 cases of healthy volunteers were selected as the control group, the prothrombin time （ PT ） , activated partial thromboplastin time（APTT） , fibrinogen （F IB ） , thrombin time （ TT） , two D-dimer （D -D ） and arterial blood gas index, blood routine index, respiratoryfunction index in the two groups were observed and compared. Results： Arterial blood pH , arterial blood P a02 , PLT, FEVi , FEVi % levelsin the case group were significantly lower than these in the control group, however, the arterial blood PaC02-,RBCW BC levels significantlyhigher than these in the control group, the differences between the two groups were statistically significant（ P 〈 0 . 0 5 ）. FIBand D-D levels in the case group were significantly higher than these in the control group, but APTT level was significantly lower thanthis in the control group, the differences were statistically significant （ P 〈 0 . 0 5 ）. Conclusion ： There was significant hypercoagulablestate and fibrinolytic hyper function in patients with AECOPD, Clinicians should take effective interventions to improve the efficacy andprognosis of patients.