老年慢性阻塞性肺疾病患者肺动脉高压与纤溶功能的关系  

Relationship between pulmonary arterial hypertension and fibrinolysis in elder patients with chronic obstructive pulmonary disease

作　　者：韩力[1] 丁怿虹[1] 肖林之[1] 张莹[1] 陈峥妍[1] 刘勤[1] 许宾[1] 时国朝[2] 

机构地区：[1]复旦大学附属上海市第五人民医院老年科,200240 [2]上海交通大学医学院附属瑞金医院呼吸科

出　　处：《中华全科医师杂志》2013年第3期205-206,共2页Chinese Journal of General Practitioners

基　　金：上海市闵行区科委项目（2009MHZ098）

摘　　要：对人院时的40例慢性阻塞性肺疾病患者检测ESR和CRP，待急性期症状平稳后检测多项凝血纤溶指标，并通过超声心动图检测肺动脉压。按肺动脉压数值分为正常和升高两组，升高组CRP和ESR明显高于正常组（P值分别为0．044和0．002）；升高组组织型纤溶酶原激活剂明显降低（P=0．04），与血栓素B2呈中度正相关性（r=0．547），血栓素B2与纤溶酶原激活剂抑制物-1呈高度正相关（r=0．929）。提示慢性阻塞性肺疾病患者的肺动脉高压伴随更大的炎症反应，并影响纤溶功能，促成血栓形成。A total of 40 patients with COPD （excluding those with correlated/relevant diseases ） were measured for inflammation parameters of erythrocyte sedimentation rate （ESR） and c-reactive protein （CRP） after hospital admission and some coagulation/fibrinolysis parameters including D-dimer, thrombinantithrombin （TAT）, prothrombin fragment 1 ＋ 2, （tissue plasminogen activator） tPA, plasminogen activator inhibitor 1 （PAI-1） , von Willebrand factor （von WF）, endothelin receptor A, thromboxane B2, P-selectin and pulmonary arterial pressure （PAP） by ultrasonic cardiography after the settling of the symptoms of acute period. All patients were then divided into 2 groups according to PAP [ 40 mm Hg （1 mmHg=0.133 kPa） （n=24）, 〉40 mm Hg （n=16）]. The values of CRP and ESRin the group with PAP 〉 40 mm Hg were significantly higher than those in another group （ P -- 0. 044 and P = 0. 002 respectively） while tPA was lower （P = 0. 04）. A moderate positive correlation existed between tPA and TXB2 （r = 0. 547）. Moreover, a highly positive correlation was found between TXB2 and PAI-1 （r = 0. 929）. The results indicated that the COPD patients with pulmonary arterial hypertension （PAH） tend to have a higher level of inflammation, and their fibrinolysis becomes impaired leading to a prothrombotic state.

关 键 词：肺疾病 慢性阻塞性 高血压 肺性 

分 类 号：R563.9[医药卫生—呼吸系统]