凝血和纤溶功能检测对慢性阻塞性肺疾病严重程度的诊断价值

The diagnostic value of coagulation and fibrinolysis test in the severity of chronic obstructive pulmonary disease

目的:探讨凝血和纤溶功能检测在慢性阻塞性肺疾病严重程度的诊断价值.方法:回顾性分析2016年1月~2018年1月的88例慢性阻塞性肺疾病患者资料,将之作为观察组的研究对象,并将同期接受体检的60例健康人群作为对照组,评定两组血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、狼疮样抗凝物质(LA),同时评定观察组患者中急性加重期和稳定期的高凝状态指标.结果:观察组的PT、APTT、TT、PIB和D-D指标明显高于对照组,差异显著(P<0.05);观察组的患者中,急性加重期的D-D水平和PaCO2水平低于稳定期患者(P<0.05),但急性加重期较之稳定期患者的LA及FIB水平比较差异不显著(P>0.05).结论:慢性阻塞性肺疾病会出现一定程度上的凝血和纤溶功能失衡,其中以急性发作期患者的血液高凝状态最为明显,LA起到了一定作用.临床应着重强调对慢性阻塞性肺疾的实时监测,并在此基础上予以针对性治疗可以有助于防止血栓形成,提高预后.

Objective: This study aims to investigate the diagnostic value of coagulation and fibrinolysis function in the severity of chronic obstructive pulmonary disease. Methods: A retrospective analysis from January 2016 to January, 2018, 88 cases of patients with chronic obstructive pulmonary disease, were used as the research object of observation group, and 60 cases of healthy people were used as a medical examination at the same time as the control group. The evaluation of two groups of plasma prothrombin time (PT), activated partial clotting enzyme live time ( APTT ), thrombin time ( TT), fibrinogen ( FIB), D -dimer ( D-D), Lupus-like anticoagulant ( LA). Meanwhile, the hypercoagulability indexes of acute exacerbation and stable period in the observation group were evaluated. Results: PT, APTT, TT, PIB and d-d indexes in the observation group were significantly higher than those in the control group (P<0.05). In the observation group, the d-d level and PaCO2 level in the acute exacerbation phase were lower than those in the stable phase (P<0.05), but the LA and FIB levels in the acute exacerbation phase were not significantly different from those in the stable phase (P>0.05). Conclusion:Chronic obstructive pulmonary disease (copd) may result in a certain degree of imbalance of coagulation and fibrinolytic function, among which the blood hypercoagulation state is the most obvious in patients with acute episode, and LA plays a certain role. Real-time monitoring of copd should be emphasized in clinical practice, and targeted treatment on this basis can help prevent thrombosis and improve prognosis.