慢性阻塞性肺疾病患者血浆纤维蛋白原水平的临床评价

Plasma Fibrinogen Measurement in Patients with Chronic Obstructive Pulmonary Disease: A Clinical Evaluation

目的 评价慢性阻塞性肺疾病 (COPD)患者血浆纤维蛋白原 (FB)水平的临床意义。方法 COPD病人 113例 ,未合并肺心病者 4 6例为B组 ;合并肺心病者 6 7例为C组。正常健康人 4 0例为A组。全部病例在稳定期间与急性发作期入院时各做一次FB、血流变与FEV1测定。每例患者随访 2年 ,记录住院次数。结果 (1)FB和血流变 :B组稳定期高于A组但仅FB和血浆粘度P <0 .0 5 ,其余P >0 .0 5 ;C组稳定期高于B组稳定期和A组 (P <0 .0 1) ;C组急发期高于B组急发期 (P <0 .0 1) ;B、C组的急发期均高于各自的稳定期 (P <0 .0 1)。 (2 )FEV1:C组稳定期低于B组稳定期 (P <0 .0 1) ,C组急发期低于B组急发期P <0 .0 1,B、C组急发期均低于各自的稳定期 (P <0 .0 1)。 (3)住院总次数C组高于B组 (P <0 .0 1)。 (4 )稳定期间的FB与FEV1的关系呈非常显著的负相关 (r=- 0 .85 ,P <0 .0 1)。结论 血浆纤维蛋白原水平升高的COPD患者 ,其并发症增加和住院率上升而肺功能减退。

Objective An evaluation of plasma fibrinogen in patients with chronic obstructive pulmonary disease. Methods 113 patients with COPD were divided into two groups. 46 of them with no complication were in group B, the other 67 cases with pulmonary heart disease were in group C. And 40 healthy in group A were included. Plasma fibrinogen, hematocrit, plasma viscosity, blood viscosity and forced expiratory volume in 1s (FEV 1) were measured with all patients in stable and exacerbation. Cumulative incidence of COPD hospitalizations from 2001 to 2003 was recorded by two years. Results Plasma fibrinogen, hematocrit, plasma viscosity and blood viscosity were significantly higher in group B than in group A, in group C than in group B and in exacerbation than in stable(P<0.01). FEV 1 was significantly lower in group C than in group B and in exacerbation than in stable(P<0.01). COPD hospitalization rates were significantly higher in group C than in group B(P<0.01). There was an inverse relation between FEV 1 and plasma fibrinogen in stable(r=-0.85,P<0.01).Conclusion Elevated plasma fibrinogen was associated with reduced FEV 1, increased risk of COPD. Fibrinogen is an independent predictor of COPD hospitalizations.