肺血栓栓塞面积与凝血功能指标的相关性分析

Correlation Analysis on Correlation between Pulmonary Thromboembolism Area and Coagulation Function Index

目的分析肺血栓栓塞面积与凝血功能指标的相关性。方法收集2016年2月至2018年2月在徐州市中心医院进行肺栓塞治疗的200例患者的临床资料,根据栓塞面积不同分为小面积组和大面积组,各100例。比较两组患者的血液生化指标(总胆固醇、三酰甘油、空腹血糖)、血气指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)]和凝血功能指标[血小板计数(PLT)、红细胞计数、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)、国际标准化比值(INR)],利用Pearson直线相关分析检验凝血功能指标与肺血栓栓塞面积的相关性。结果小面积组的PLT低于大面积组[(119.1±22.3)×10^9/L比(199.2±43.2)×10^9/L](P<0.01),PaO2、PaCO2高于大面积组[(68.2±10.4)mmHg(1 mmHg=0.133 kPa)比(60.5±8.0)mmHg,(36.6±3.9)mmHg比(31.6±5.8)mmHg](P<0.05)。小面积组的PT和APTT显著短于大面积组[(11.58±0.35)s比(17.42±0.78)s,(26.12±0.18)s比(35.05±0.28)s],而TT长于大面积组[(16.12±0.29)s比(13.12±0.11)s],FIB水平低于大面积组[(2.73±0.47)g/L比(3.31±0.40)g/L](P<0.01),小面积组与大面积组的INR比较差异无统计学意义(P>0.05)。Pearson直线相关分析结果显示,PT、APTT、FIB与肺血栓栓塞面积大小呈正相关(r=0.714,r=0.852,r=0.633,均P<0.001),TT与肺血栓栓塞面积大小呈负相关(r=-0.650,P<0.001),INR与肺血栓栓塞面积大小无相关性(r=0.234,P=0.857)。结论不同肺栓塞面积与凝血功能部分指标密切相关,其中PT、APTT、FIB、TT是反映患者病情严重程度的有效指标,对于评估患者预后和制订合理的诊治方案具有积极作用。

Objective To analyze the correlation between the area of pulmonary thromboembolism and coagulation function index.Methods The clinical data of 200 patients who underwent pulmonary embolism treatment at Xuzhou Central Hospital from Feb.2016 to Feb.2018 was collected.According to the different embolism areas,they were divided into a small area group and a large area group,with 100 cases in each.The blood biochemical indexes(total cholesterol,triacylglycerol,fasting blood glucose),blood gas indexes[arterial partial pressure of oxygen(PaO 2),arterial partial pressure of carbon dioxide(PaCO2)]and coagulation function indexes[platelet count(PLT),red blood cell count,prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),international normalized ratio(INR)]of the two groups were compared,using Pearson linear correlation analysis to test the correlation between coagulation function indexes and pulmonary thromboembolism area.Results The PLT of the small area group was lower than that of the large area group[(119.1±22.3)×10^9/L vs(199.2±43.2)×10^9/L](P<0.01),PaO 2 and PaCO 2 were higher than those of the large area group[(68.2±10.4)mmHg vs(60.5±8.0)mmHg,(36.6±3.9)mmHg vs(31.6±5.8)mmHg](P<0.05).The PT and APTT of the small area group were significantly shorter than those of the large area group[(11.58±0.35)s vs(17.42±0.78)s,(26.12±0.18)s vs(35.05±0.28)s],while TT was longer than that of the large area group[(16.12±0.29)s vs(13.12±0.11)s],FIB level was lower than that of the large area group[(2.73±0.47)g/L vs(3.31±0.40)g/L](P<0.01).There was no significant difference in INR between the two groups(P>0.05).Pearson linear correlation analysis showed that PT,APTT,FIB were positively correlated with the area of pulmonary thromboembolism(r=0.714,r=0.852,r=0.633,all P<0.001),and TT was negatively correlated with the area of pulmonary thromboembolism(r=-0.650,P<0.001),there was no correlation between INR and the area of pulmonary thromboembolism(r=0.234,P=0.857).Conclusion Different areas of pulmonary embolism are closely related to some indicators of coagulation function,among which,PT,APTT,FIB,and TT are effective indicators to reflect the severity of the patient′s condition,and play a positive role in assessing the prognosis and formulating the reasonable diagnosis and treatment plans.