慢性阻塞性肺疾病急性加重期凝血功能与血气指标的相关性研究

Correlation study between coagulation function and arterial blood gas indexes in acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重患者凝血功能与动脉血气指标的相关性。方法选取我院2013年6月~2015年8月收治的56例慢性阻塞性肺疾病急性加重患者作为A组,治疗后为B组,另选取在我院接受体检的56例健康者作为C组,测定所有研究对象的纤维蛋白原(Fbg)、D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT),氧分压(PaO_2)、二氧化碳分压(PaCO_2),分析凝血功能指标与动脉血气指标的相关性。结果三组的PT、APTT、TT水平比较,差异无统计学意义(P>0.05);A组的D-D、Fbg、PaCO_2水平高于B、C两组,差异有统计学意义(P<0.05);PaO_2水平低于B、C组,差异有统计学意义(P<0.05)。A组的D-D与PaO_2成负相关,差异有统计学意义(r=-0.232,P<0.05);D-D与PaCO_2成正相关,差异有统计学意义(r=0.284,P<0.05);Fbg与PaCO_2成正相关,差异有统计学意义(r=0.437,P<0.05);Fbg与PaO_2成负相关,差异有统计学意义(r=-0.465,P<0.05)。结论慢性阻塞性肺疾病急性加重期患者存在血液高凝状态,监测D-D与Fbg指标为患者及时采取抗凝措施改善预后提供一定的数据基础。

Objective To explore the correlation between coagulation function and arterial blood gas indexes in acute exacerbation of chronic obstructive pulmonary disease.Methods 56 patients with acute exacerbation of chronic obstruc rive pulmonary disease admitted to our hospital from June 2013 to August 2015 were selected as group A,after treatment were selected as group B,on the other hand,56 healthy persons for physical examination in our hospital were selected as group C.The level of fibrinogen （Fbg）,D- two dimer （D-D）,prothrombin time （PT）,activated partial thromboplastin time （AF1T）,thrombin time （IT）,oxygen partial pressure （PaO2）,partial pressure of carbon dioxide （PaCO2） of all the research object were determined,the correlation between blood coagulation function index and arterial blood gas indexes was an- alyzed.Results There was no significant difference in the level of PT,APTT and TT between the three groups （P〉0.05）;the levels of D-D,Fbg,PaCO2 in group A was higher than that in group B and group C,the difference was statistically significant （P〈0.05）, and the PaO2 level was lower than that of B and C group, the difference was statistically significant （P〈 0.05）.There are negative correlation between D-D and PaO2,the difference was statistically significant （r=-0.232,P〈0.05）; D-D was positively correlated with PaCO2,the difference was statistically significant （r=0.284,P〈0.05）;Fbg was positively correlated with PaCO2,the difference was statistically significant （r=0.437,P〈0.O5）;Fbg was negatively correlated with PaO2, with significant difference （r=-0.465,P〈0.05）.Conclusion There is a high coagulation state in acute exacerbation of chronic obstructive pulmonary disease,and the monitoring of D-D and Fbg indexes can provide a certain data base for the improvement of prognosis.