老年COPD合并肺心病患者血栓前状态的研究  

A study of prethrombotic state in senile patients with chronic obstructive pulmonary disease and pneumocardial disease

作　　者：宋雅君[1] 周哲慧[1] 柳耀康 饶世明[1] 黄颖俊 

机构地区：[1]上海市黄浦区中心医院内科,上海200002

出　　处：《临床肺科杂志》2011年第9期1378-1380,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨老年COPD合并肺心病患者血栓前状态多种指标参数的变化。方法检测50例老年肺心病急性加重期患者凝血功能(PT,APTT,TT);纤维蛋白原(FBG);D-二聚体;血液流变学指标,包括红细胞压积、全血粘度、血浆粘度(高切、低切);以及肺动脉收缩压(SPAP)、氧分压等指标,并同肺心病缓解期和正常健康老人相比较。结果老年COPD合并肺心病急性发作期与其缓解期以及对照组相比,PT,APTT,TT缩短,FBG,D-二聚体上升,差异有显著性;红细胞压积、血浆粘度、全血粘度升高,差异有显著性;SPAP增大,差异有显著性;老年COPD合并肺心病急性发作期患者的PaCO2与D-二聚体、FBG成正相关,PaO2与全血高切粘度、D-二聚体、FBG成负相关。结论血浆D-二聚体,FBG,血液流变学,凝血功能,SPAP的监测对评估疾病严重程度及其预后以及疗效观察提供有力的依据。Objective To study the clinical value of prethrombotic state in senile patients with chronic obstructive pulmonary disease and pneumocardial disease.Methods The plasma coagulation parameters of prothombin time（PT）,partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（FBG）,D-dimer,the hemorheological indexes of hematocrit（HCT）,blood viscosity（BV）,plasma viscosity（PV）,and pulmonary arterial pressure（SPAP） were determined at acute episode phase and remission phase,and were compared with that of control group.Result The levels of FBG,D-dimer,HCT,BV,PV and SPAP were significantly increase（P0.01） and PT,APTT,TT were significantly shorten at acute episode phase in senile patients with chronic obstructive pulmonary disease and pneumocardial disease compared to those in the healthy subjects and those at remission phase.The plasma D-dimer,FBG had a significantly positive correlation with PaCO2 and negative correlation with PaO2.Conclusion The levels of FBG,D-dimer,HCT,BV,PV and PT,APTT,TT,SPAP in senile patients with chronic obstructive pulmonary disease and pneumocardial disease may provide the severity and prognosis of prethrombotic state.

关 键 词：老年COPD 肺心病 纤维蛋白原 凝血功能 D-二聚体 血液流变学 肺动脉高压 

分 类 号：R563.9[医药卫生—呼吸系统] R541.5[医药卫生—内科学]