慢性阻塞性肺疾病急性加重期凝血纤溶状况分析

目的探讨慢性阻塞性肺疾病（COPD）急性加重期患者凝血纤溶异常情况,并探究其临床意义。方法收集COPD患者60例为研究对象（急性加重期患者34例,稳定期患者26例）,并选取50例健康志愿者为对照组;检测所有入选对象的血浆凝血酶原时间（PTT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、血小板（PLT）、D-二聚体（D-D）和狼疮样抗凝物质（LA）的水平。结果 COPD患者PTT、APTT较对照组明显延长（P〈0.05）,FIB、D-D、LA比值、PLT等凝血指标均明显高于对照组（P〈0.05）。COPD急性加重期D-D值和PaCO2值均明显高于COPD稳定期（P〈0.05）,PaO2明显低于COPD稳定期（P〈0.05）,而LA比值、FIB二者比较,差异无统计学意义（P〉0.05）。结论 COPD患者血液处于高凝状态,而急性加重期的高凝低纤状态更有利于血栓的形成,对监测COPD病情变化具有重要意义。

Blood Coagulation and Fibrinolysis in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To investigate the coagulation and fibrinolysis abnormalities and their clinical significance in acute exacerbation of chronic obstructive pulmonary disease（COPD）.Methods The plasma prothrombin time（PTT）,activated partial thromboplastin time（APTT）and levels of fibrinogen（FIB）,platelets（PLT）,lupus anticoagulant（LA）and D-dimer（DD）were determined in 60patients with COPD（34patients with acute exacerbation of COPD and 26patients with stable COPD）and 50healthy subjects.Results Compared with healthy subjects,the PTT and APTT were prolonged and levels of FIB,DD,LA and PLT were reduced in patients with COPD（P〈0.05）.Compared with patients with stable COPD,DD level and PaCO2were increased and PaO2was decreased in patients with acute exacerbation of COPD（P〈0.05）.However,there were no significant differences in levels of LA and FIB between patients with stable COPD and patients with acute exacerbation of COPD（P〉0.05）.Conclusion A hypercoagulable state exists in patients with COPD.The hypercoagulable and hypofibrinolytic state in acute exacerbation of COPD is more conducive to the thrombosis and is of great significance for the monitoring of COPD.