同型半胱氨酸及载脂蛋白A/载脂蛋白B水平与慢性阻塞性肺疾病患者凝血指标相关性的研究  

Correlation Analysis between Levels of Homocysteine Apolipoprotein A/Apolipoprotein B and Coagulation Indexes in Patients with Chronic Obstructive Pulmonary Disease

作　　者：赵雪锋 韩京旭 岳红云 刘姣姣 ZHAO Xuefeng;HAN Jingxu;YUE Hongyun(Shijiazhuang People's Hospital,Hebei Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市人民医院呼吸内科一病区,河北石家庄050000

出　　处：《河北医学》2021年第9期1562-1566,共5页Hebei Medicine

基　　金：河北省医学科学研究重点课题计划,(编号:20191483)。

摘　　要：目的:分析慢性阻塞性肺疾病(COPD)患者血清同型半胱氨酸(Hcy)及载脂蛋白A1(Apo A1)/载脂蛋白B100(Apo B100)水平与凝血指标的相关性。方法:将我院2017年1月至2019年12月收治的188例COPD患者分为静脉血栓栓塞症(VTE)组(n=92)和非VTE组(n=96),对比两组患者的一般资料和血清Hcy、Apo A1、Apo B100、Apo A1/Apo B100水平以及活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶原时间(PT);血浆粘度(PV)、D-二聚体(D-D)和抗凝血酶Ⅲ(ATⅢ)活性等凝血指标,并分析COPD患者血清Hcy、Apo A1、Apo B100、Apo A1/Apo B100水平与凝血指标的相关性。结果:VTE组患者血清Hcy、Apo B100、FIB、PV及D-D水平明显高于非VTE组(P<0.05或P<0.01);VTE组患者血清Apo A1、Apo A1/Apo B100和AT-Ⅲ水平明显低于非VTE组(P<0.05或P <0.01)。COPD患者血清中Hcy和Apo B100水平与FIB、PV及D-D等凝血指标存在明显的正相关(P均<0.001),与AT-Ⅲ存在明显的负相关(P<0.001);而Apo A1和Apo A1/Apo B100水平与FIB、PV及D-D等凝血指标存在明显的负相关(P均<0.001),与AT-Ⅲ存在明显的正相关(P<0.001)。结论:COPD患者血清中Hcy、Apo A1、Apo B100、Apo A1/Apo B100水平与VTE发生存在相关性,在临床上监测血清Hcy、Apo A1及Apo B100水平,对评估COPD患者VTE发生具有重要价值。Objective: To analyze the correlation between level of serum homocysteine( Hcy),apolipoprotein A1( Apo A1)/apolipoprotein B100( Apo B100) and blood coagulation indexes in patients with chronic obstructive pulmonary disease( COPD). Methods: The 188 COPD patients admitted to our hospital from Jan 2017 to Dec 2019 were divided into venous thromboembolism( VTE) group( n = 92) and non-VTE group( n = 96),and the general information of the two groups were compared. Other items of the two groups were compared too,including serum Hcy,Apo A1,Apo B100,Apo A1/Apo B100 levels and coagulation indexes such as activated partial thromboplastin time( APTT),fibrinogen( FIB),prothrombin time( PT),plasma viscosity( PV),D-dimer( DD) and antithrombin Ⅲ( AT-Ⅲ) activity. Then correlation analysis between serum Hcy,Apo A1,Apo B100,Apo A1/Apo B100 levels and coagulation indexes of COPD patients were performed. Results: The serum levels of Hcy,Apo B100,FIB,PV and DD in the VTE group were significantly higher than those in the non-VTE group( P <0.05 or P <0.01). The serum levels of Apo A1,Apo A1/Apo B100 and AT-Ⅲ in the VTE group was significantly lower than those in the non-VTE group( P <0.05 or P <0.01). The levels of Hcy and Apo B100 in the serum of patients with COPD are significantly positively correlated with FIB,PV,and DD and other coagulation indicators( P <0.001),and significantly negatively correlated with AT-Ⅲ( P <0.001);while Apo A1 and Apo A1/Apo B100 level is significantly negatively correlated with FIB,PV,DD and other coagulation indicators( P <0.001),and there is a significant positive correlation with AT-Ⅲ( P <0.001). Conclusion: Serum Hcy,Apo A1,Apo B100,Apo A1/Apo B100 levels in COPD patients are correlated with the occurrence of VTE. Clinical monitoring of serum Hcy,Apo A1 and Apo B100 levels is of great value in evaluating the occurrence of VTE in COPD patients.

关 键 词：慢性阻塞性肺疾病 同型半胱氨酸 载脂蛋白A1 载脂蛋白B100 凝血指标 

分 类 号：R563.9[医药卫生—呼吸系统]