慢性肺心病急性加重期血液高凝状态与肺功能的相关性研究  

The Relation Between Hypercoagulable State and Pulmonary Function in Patients with Cor Pulmonale During Exacerbation Period

作　　者：黄林锋[1] 蔡建生[1] 叶志华[1] 曾昭孟 

机构地区：[1]广东省汕头市第二人民医院内二科,广东汕头515011

出　　处：《河北医学》2010年第10期1160-1163,共4页Hebei Medicine

基　　金：广东省汕头市科技局重点科技项目2009-9

摘　　要：目的:了解肺心病患者急性加重期高凝状态与肺功能的相关性,探讨肺心病患者在常规治疗基础上,配合有效的降纤、抗凝治疗,是否有利于改善肺心病患者肺功能。方法:将78例肺心病急性加重期患者随机分成治疗组(常规治疗同时采用氯吡格雷钠和低分子肝素进行干预性治疗,39例)和对照组(仅采用常规治疗,39例),另设一健康人组。治疗前后同步检测患者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fb)和肺功能(FEV1),并与32例同龄健康者进行比较。结果:①两组慢性肺心病急性加重期患者治疗前分别与健康组比较,Fb显著高于健康组(P<0.01),PT、APTT、TT和FEV1显著低于健康组(P<0.05),此两组间上述指标无差别(P>0.05);②治疗组(常规治疗同时加用氯吡格雷钠和低分子肝素治疗)治疗后较治疗前Fb显著降低(P<0.01),PT、APTT、TT和FEV1显著升高(P<0.05);③对照组治疗前后PT、APTT、TT、Fb各项指标略有改善,但无显著性差异(P>0.05),肺功能(FEV1)有改善(P<0.05);④治疗后治疗组与对照组之间的检测指标的比较,PT、APTT、TT、Fb和FEV1均有显著性差异(P<0.05)。结论:①肺心病患者急性加重期其血液呈高凝状态,肺功能明显下降;②常规治疗并配合有效的抗凝、降纤治疗能有效改善肺心病急性加重期血液的高凝状态,同时有效改善患者肺功能,提高肺心病治疗效果。Objective： To investigate the relation between hypercoagulable state and pulmonary function in the patients with cor pulmonale during exacerbation period,and study whether to improve the patients pulmonary function by correcting the hypercoagulable state of cor pulmonale besides routine treatment.Method： 78 cases patients with cor pulmonale in exacerbation period were randomly divided into clopidogrel and low molecular heparin group（39 cases） and control group（39 cases）.The forced expiratory volume in 1st（FEV1%） and the plasma coagulation parameters of prothrombin time（PT）,partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（Fb） were determined in 2 groups before and after treatment.32 cases healthy human subjects proceed comparison with clopidogrel and low molecular heparin group and control group.Result： ①Before the treatment,the levels of Fb was significantly increased（P〈0.01）,and the levels of FEV1 PT,APTT and TT were significantly decreased（P 〈0.05） in clopidogrel and low molecular heparin group and control group in exacerbation period compared with healthy subjects,but in clopidogrel and low molecular heparin group and control group showed no difference（P 〉 0.05）.②After the treatment,in clopidogrel and low molecular heparin group the levels of Fb was significantly decreased（P 〈 0.01）,and the levels of FEV1,PT,APTT and TT were significantly increased（P 〈 0.05）.③The difference before and after treatment were no significant difference in control group,except for FEV1%（P〈0.05）.④Compared with those of control group after treatment,the level of PT,APTT in clopidogrel and low molecular heparin group were longer and the level of Fb and FEV1% increased（P〈0.05）.Conclusion： ①The patients of cor pulmonale in exacerbation period could cause hypercoagulable state and decrease pulmonary function.②Besides routine treatment,given anti-coagulation,decrease of blood viscosity and the level of fibrinogen therapy could correct th

关 键 词：慢性肺心病 高凝状态 凝血酶原时间 活化部分凝血活酶时间 凝血酶时间 纤维蛋白原 肺功能 

分 类 号：R541.5[医药卫生—心血管疾病]