凝血功能指标与老年心力衰竭合并重症肺炎病人预后的相关性分析  

Correlation between coagulation function and prognosis of elderly patients with severe pneumonia complicated with heart failure

作　　者：康文娥 张玉林[2] KANG Wen-e;ZHANG Yu-lin.(Physical Examination Center, Beijing Haidian Hospital, Beijing 100080, China;Beijing Youan Hospital Affiliated to Capital Medical University, Beijing 100069, Chin)

机构地区：[1]北京市海淀医院体检中心,北京市100080 [2]首都医科大学附属北京佑安医院,北京市100069

出　　处：《实用老年医学》2018年第6期560-562,567,共4页Practical Geriatrics

基　　金：国家自然科学基金(81371399);国家12.5重大科技专项基金(2012ZX10001-002;2012ZX10001-003;2012ZX10001-004)

摘　　要：目的观察老年心力衰竭(心衰)合并重症肺炎病人的凝血功能指标的变化,并分析其临床意义。方法选取2013年7月至2016年9月我院收治的老年心衰合并重症肺炎病人126例为心衰合并重症肺炎组,选取单纯老年重症肺炎病人52例为重症肺炎组,另选取老年普通肺炎病人26例为对照组。心衰合并重症肺炎组病人根据其临床转归分为存活亚组87例与死亡亚组39例。检测并比较各组病人的凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)、纤维蛋白原(FIB)、血小板计数(PLT),并分析各指标与老年心衰合并重症肺炎病人预后的相关性。结果与对照组、重症肺炎组相比,心衰合并重症肺炎组病人的TT、APTT、PT、D-D显著升高,FIB、PLT显著降低(P<0.05),且重症肺炎组病人的TT、APTT、PT、D-D显著高于对照组,FIB、PLT显著低于对照组(P<0.05);心衰合并重症肺炎组病人中,死亡亚组病人的TT、APTT、PT、D-D显著高于存活亚组,FIB、PLT显著低于存活亚组(P<0.05);Pearson相关性分析显示,TT、APTT、PT、D-D与心衰合并重症肺炎病人的预后呈负相关,FIB、PLT与心衰合并重症肺炎病人的预后呈正相关(P<0.05)。结论老年心衰合并重症肺炎病人存在凝血功能异常,凝血功能指标与心衰合并重症肺炎病人的预后存在显著相关性,可用于判断病人病情及预后。Objective To observe the changes of coagulation function in elderly patients with heart failure complicated with severe pneumonia,and to analyze its clinical significance. Methods From July 2013 to September 2016,126 elderly patients with heart failure complicated with severe pneumonia were selected as heart failure complicated with severe pneumonia group,and 52 elderly patients with severe pneumonia were selected as severe pneumonia group. In addition,26 elderly patients with common pneumonia were selected as control group. Patients with heart failure complicated with severe pneumonia were divided into survival subgroup（ 87 cases） and death subgroup（ 36 cases）. The levels of thrombin time（ TT）,activated partial thromboplastin time（ APTT）,prothrombin time（ PT）,D-dimer（ D-D）,fibrinogen（ FIB）,platelet count（ PLT） were measured and compared in each group,and the correlation between indexes and prognosis of senile heart failure complicated with severe pneumonia was analyzed.Results Compared with the control group and severe pneumonia group,the levels of TT,APTT,PT,DD were significantly increased,and the levels of FIB,PLT were significantly decreased（ P〈0. 05） in heart failure complicated with severe pneumonia group. The levels of TT,APTT,PT,D-D in severe pneumonia group were significantly higher than those in control group,and the levels of FIB,PLT in severe pneumonia group were significantly lower than those in control group（ P〈0. 05）. The levels of TT,APTT,PT,D-D in death subgroup were significantly higher,and the levels of FIB,PLT were significantly lower in death subgroup than those in survival subgroup（ P〈0. 05）. The levels of TT,APTT,PT and D-D were negatively correlated with the prognosis of patients with severe pneumonia with heart failure,and the levels of FIB,PLT were positively correlated with the prognosis of patients with severe pneumonia with heart failure（ P〈0. 05）. Conclusions There is abnormal coagulation function in elderly patients with heart

关 键 词：心力衰竭 重症肺炎 老年人 凝血功能 

分 类 号：R541.6[医药卫生—心血管疾病]