慢性呼吸衰竭患者血栓前状态的研究  

The study of prethrombotic state in patients with chronic respiratory failure

作　　者：姜正华[1] 吕元文[1] 桑慧颖[1] 朱慕云[1] 朱湘平[1] 丁平[1] 

机构地区：[1]扬州大学临床医学院江苏省苏北人民医院呼吸内科,江苏省扬州225001

出　　处：《中华急诊医学杂志》2007年第1期75-77,共3页Chinese Journal of Emergency Medicine

摘　　要：目的 探讨慢性呼吸衰竭患者凝血指标与血气分析的相关性。方法 分别进行测定28例慢性呼吸衰竭患者治疗前后血气分析、凝血指标及28例对照组的凝血指标。结果 慢性呼吸衰竭患者血浆D-二聚体、血浆纤维蛋白原、纤维蛋白降解产物、凝血酶原时间、部分活化凝血活酶时间水平在明显升高，治疗后明显下降。血浆抗凝血酶Ⅲ、凝血因子Ⅱ水平在慢性呼吸衰竭患者明显降低。血浆D-二聚体、血浆纤维蛋白原、纤维蛋白降解产物与血氧分压呈负相关，与血二氧化碳分压呈正相关。结论 慢性呼吸衰竭患者存在高凝状态，并容易导致肺小动脉血栓形成。低氧血症、高碳酸血症与高凝状态的形成密切相关。临床治疗中适当的抗凝治疗对控制慢性呼吸衰竭患者病情的可能有益。Objective To investigate correlation between coagulation markers and blood gas analysis in patients with chronic respiratory failure （CRF） . Method The coagulation markers were measured in 28 CRF patients and in 28 controls. Blood gas analysis was measured in 28 CRF patients. Results The D-dimer, fibrinogen degration products, thromhinogen time, active partial thromboplastin time and plasma fibrinogen were significantly higher in CRF patients than in controls, and then significantly decreased. The plasma antithrombin Ⅲ and coagulation factor Ⅱ were significantly lower in CRF patients than in controls. The D-dimer level, plasma fibrinogen and fibrinogen degration products were negatively correlated with PaO2, but they were positively correlated with PaCO2. Conclusions The patients with chronic respiration failure were in a state of high coagulation and contributed to thromh in small pulmonary artery. Hypoxemia and hypereapnia were connected with high coagulation. The anti-coagulability medicine treatment might benefit patients with chronic respiratory failure patients.

关 键 词：慢性呼吸衰竭 慢性阻塞性肺疾病 血栓前状态 血气分析 

分 类 号：R686[医药卫生—骨科学]