慢性阻塞性肺疾病患者凝血功能和纤溶状态的变化分析  

Coagulation and fibrinolysis states in patients with chronic obstructive pulmonary disease

作　　者：杨丽红[1] 王明山[1] 金艳慧[1] 谢海啸[1] 张卓[1] 林映[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000

出　　处：《中国卫生检验杂志》2010年第6期1465-1466,共2页Chinese Journal of Health Laboratory Technology

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)患者凝血功能和纤溶状态的变化及其对疾病进展和预后的影响。方法:以73例COPD急性加重期和61例COPD稳定期患者为研究对象,60例健康体检者选为对照。分别检测其血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)、血小板(PLT)、D-二聚体(D-D)、狼疮样抗凝物质(LA)和动脉血二氧化碳分压(PaCO2)水平,进行比较分析。结果:COPD组的PT和APTT较健康对照组显著延长(P<0.01),FIB、D-D、PLT水平和LA比值均较健康对照组显著升高(P<0.01)。COPD急性加重期组的D-D和动脉血PaCO2水平明显低于COPD稳定期组(P<0.05),但FIB水平和LA比值在两组间无显著性差异(P>0.05)。结论:COPD患者存在血液高凝状态,LA起到了一定作用;COPD急性加重期患者的高凝低纤状态更利于血栓形成。Objective：To study the coagulation and fibrinolysis states in patients with chronic obstructive pulmonary disease（COPD）,and its impact on the progression and prognoses of the disease.Methods：61 stable patients with COPD,73 acute exacerbation of COPD and 60 healthy adults as controls were studied.Prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,platelet（PLT）,D-dimer（D-D）,lupus-type anticoagulants（LA） and arterial partial pressure of carbon dioxide（PaCO2） of the groups were measured and analyzed.Results：COPD patients had significant increase in PT,APTT,FIB,D-D,PLT and the ratio of LA compared with healthy group（P〈0.01）.It showed obviously decrease in D-D and PaCO2 in acute exacerbation group compared with stable group（P〈0.05）,but FIB and the ratio of LA were no significant difference（P〉0.05）.Conclusion：The patients with COPD have hypercoagulability.The higher LA maybe is an important reason to enhance hypercoagulabale state.The hypercoagulability and low fibrinolysis of acute exacerbation of COPD is more conducive to thrombosis.

关 键 词：慢性阻塞性肺疾病 凝血 纤溶 狼疮样抗凝物质 

分 类 号：R563.5[医药卫生—呼吸系统]