辛伐他汀对慢性阻塞性肺疾病急性加重期患者凝血功能的影响研究

The Clinic Effect of Simvastatin on Blood Coagulation Function in Patients with AECOPD

目的:探讨辛伐他汀对慢性阻塞性肺疾病急性加重期(chronic obstructive pulmonary acute exacerbation,AECOPD)患者凝血功能的影响。方法:选取2019年8月~2020年8月我科住院治疗的80例AECOPD患者作为本次研究对象,随机性分为对照组和观察组,每组分别40例。对照组给予常规治疗措施,观察组在对照组的治疗基础上另予辛伐他汀口服。比较两组患者刚入院时、治疗10 d后、30 d后的凝血功能指标、呼吸机使用时间、住院时间及治疗费用。治疗30天后所有患者按照肺功能损害严重程度分级,比较各级患者的凝血功能指标。结果:治疗后10 d和30 d,观察组患者的D-二聚体(D-dimer,DD)、同型半胱氨酸(homocysteine,HCY)及纤维蛋白原(fibrinogen,FBG)水平均明显减低,凝血酶时间(thrombin time,TT)明显缩短,凝血酶原时间(prothrombin time,PT)及活化部分凝血酶时间(activation of partial thrombin time,APTT)明显变长,各项指标与对照组相比较具有统计学意义(P<0.05)。观察组呼吸机使用时长及住院天数均明显低于对照组,治疗费用也明显低于对照组,其差异具有统计学意义(P<0.05)。治疗30天后按照肺功能中度损害患者的DD、HCY、FBG水平均显著低于重度和极重度患者,TT显著短于重度和极重度患者,PT和APTT显著长于重度和极重度患者(P<0.05);重度肺功能损害患者的DD、HCY、FBG水平均显著低于极重度患者,TT显著短于极重度患者,PT和APTT显著长于极重度患者(P<0.05)。结论:辛伐他汀能够明显改善AECOPD患者的凝血功能,缩短住院时间,慢阻肺患者肺功能损害程度与其凝血功能异常程度存有一定关联性,肺功能损害程度较重者其凝血功能异常更为明显。

Objective:To explore the clinic effect of simvastatin on the blood coagulation function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 80 patients with AECOPD were collected and randomlyizd divided into the observation group and control group,with 40 cases in each group was 40 cases.Patients in the control group were treated with routine treatment,while patients in the observation group were treated with oral simvastatin on the basisbesides the of standard treatment.The changes of coagulation before and the 10 th,30 th day after treatment,ventilator use time,hospitalization time and treatment cost were compared between the two groups.After 30 days of treatment,all patients were graded according to the severity of pulmonary lung function impairment,and the coagulation function indicators of patients at all levels were compared.Results:After the10 th,30 th day of treatment,the levels of DD,HCY and FBG in the observation group were significantly reduced,TT was significantly shortened,PT and APTT were significantly prolonged,and all indicators were significantly better than the control group,all above had statistical difference(P<0.05).The ventilator use time and hospitalization time in the observation group were significantly shorter than those in the control group,and the treatment cost in the observation group was significantly lower than that of the control group,all above had statistical difference(P<0.05).After 30 days of treatment,the DD,HCY,and FBG levels of patients with moderate impairment of pulmonary lung function were significantly lower than those of severe and very severe patients.TT was significantly shorter than patients with severe and severe PT,PT and APTT were significantly longer than patients with severe and severe cases(P<0.05).The levels of DD,HCY and FBG in patients with severe pulmonary dysfunction were significantly lower than those in extremevery severe patients.TT was significantly shorter than that in very severe patients,and PT and APTT were significantly longer than those in very severe patients(P<0.05).Conclusion:Simvastatin can significantly improve the coagulation function of patients with AECOPD and shorten the length of hospital stay.The degree of lung function damage in patients with chronic obstructive pulmonary disease has a certain correlation with the degree of abnormal blood coagulation function.The abnormal blood coagulation function is more obvious in patients with severe lung function damage.