慢性阻塞性肺疾病急性加重期血浆凝血与纤溶标志物的变化及其意义

Changes and significance of plasma coagulation and fibrinolysis markers in prethrombotic state of patients with acute exacerbation of chronic obstructive pulmonary disease

目的通过观察慢性阻塞性肺疾病急性加重期(AECOPD)凝血及纤溶异常情况,探讨其临床意义。方法收集AECOPD患者58例为研究对象,并选取35例健康志愿者为对照组,检测血浆血栓调节蛋白(TM)、凝血酶-抗凝血酶Ⅲ复合物(TAT)、组织型纤溶酶原激活剂-抑制剂1复合物(t-PAIC)、纤溶酶-α2纤溶酶抑制剂复合物(PIC)、凝血酶时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶原时间(TT)、与D-二聚体的变化。结果 AECOPD患者TAT、PIC、t-PAIC、PT、FIB、TT、D-二聚体与对照组相比,差异有统计学意义(P<0.05)。AECOPD患者TAT与PIC呈正相关,与TT呈负相关,PIC与PT、TT呈负相关,与FIB、D-二聚体呈正相关,FIB与TT呈负相关,与D-二聚体呈正相关(P<0.05)。结论 AECOPD患者血液处于高凝状态,更易于血栓形成,利用上述凝血与纤溶指标对判断AECOPD患者血栓前状态有重要意义。

Objective To investigate the clinical significance of coagulation and fibrinolysis in acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods A total of 58 patients with AECOPD were enrolled in this study.35 healthy volunteers were selected as the control group.The plasma TM,TAT,t-PAIC,PIC,PT,APTT,FIB,TT,and D-two dimer were detected. Results The levels of TAT,PIC,t-PAIC,PT,FIB,TT and D-two dimer in AECOPD patients were significantly higher than those in control group （ P 〈0.05）.There was a positive correlation between TAT and PIC in AECOPD and negative correlation with TT;PIC was negatively correlated with PT and TT,and was positively correlated with FIB and D-two dimer;FIB was negatively correlated with TT,and was positively correlated with D-twodimer （ P 〈0.05）. Conclusion The blood of AECOPD patients is in the state of hypercoagulability and is more prone to thrombosis.It is of great significance to use the above coagulation and fibrinolysis index to judge the prethrombotic state of AECOPD patients.