慢性阻塞性肺疾病急性加重期的凝血纤溶异常情况探讨简

目的 通过观察慢性阻塞性肺疾病（COPD）及COPD急性加重期的凝血纤溶异常情况,探讨其临床意义.方法 收集COPD患者120例为研究对象,并选取80例健康志愿者为对照;检测血浆凝血酶原时间（PTT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、血小板（PLT）与D-二聚体（D-D）的变化.结果 COPD患者PTT、APTT较对照组明显延长（t=3.732、10.430,P〈0.05）,FIB、D-D、PLT等凝血指标均明显高于对照组相应指标值,COPD患者急性加重期D-D值和PaCO2值均明显高于COPD稳定期（t=4.689、2.032,P〈0.05）,PaO2明显低于COPD稳定期（t=4.553,P〈0.05）,而FIB两组比较,差异无统计学意义（P〉0.05）.结论 COPD患者血液处于高凝状态,而急性发作期的高凝低纤状态更有利于血栓的形成.

Discussion of abnormal coagulation and fibrinolysis in AECOPD patients

Objective To investigate the clinical significance of abnormal coagulation and fibrinolysis in AECOPD patients. Methods 120 patients with COPD were selected in this study, which included 68 patients at a- cute exacerbation stage and 52 patients at stable stage, and another 80 healthy volunteers were taken as the control group. Plasma prothrombin time （PTY）, activated partial thromboplastin time （AVIT）, fibrinogen （FIB）, platelets （PLT） and D-dimer （DD） were detected. Results FIT and AFFF were significantly longer in the COPD group than in the control group （t =3. 732 and 10. 430, P 〈0. 05） , and the values of FIB, DD, PLT and other coagulation pa- rameters were significantly higher in the COPD group than in the control group （ P 〈 0. 05 ）. The levels of DD and PaCO2 were significantly higher and the level of PaO2 was lower in the acute exacerbation group than in the stable group （ P 〈 0. 05 ）. There was no significant difference in FIB between the two groups （ P 〉 0. 05 ）. Conclusion The blood of COPD patients is in a hypercoagulable state, and the state of hyper-coagulation and low-fiber is more conducive to thrombosis.