慢性呼吸衰竭患者血浆凝血指标测定的临床意义

目的 探讨慢性呼吸衰竭患者治疗前后凝血指标的变化及其临床意义.方法 对65例慢性呼吸衰竭患者（观察组）治疗前及治疗后1、3、7 d及50例对照组患者的血气分析、凝血指标分别进行测定.结果 观察组患者治疗前与对照组相比,纤维蛋白原、D-二聚体、纤维蛋白降解产物浓度明显上升,抗凝血酶Ⅲ、凝血因子Ⅱ的浓度有所降低;经治疗后1、3、7 d, 动脉血pH值、PaO2明显升高,PaCO2明显下降,血液的高凝状态有所减轻,与治疗前相比,各凝血指标变化均具有统计学意义（P〈0.05）,治疗后7 d血浆凝血指标与对照组相比无统计学意义（P〉0.05）;观察组治疗前PaO2与血浆D-二聚体、FIB、FDP浓度呈显著负相关（P〈0.01）,PaCO2与血浆D-二聚体、FIB、FDP浓度呈显著正相关（P〈0.01）.结论 低氧血症、高碳酸血症与慢性呼吸衰竭患者高凝状态的形成密切相关,在临床治疗中给予患者适当的活血抗凝治疗对改善患者转归与预后有重要价值.

Clinical significance of plasma coagulation markers in patients with chronic respiration failure

Objective To investigate the change of coagulation markers in patients with chronic respiration failure. Methods The blood gas analysis and the blood coagulation markers was measured in 65 patients with chronic respiratory failure and 50 normal patients. Results The D -dimer, fibrinogen degration products and plasma fibrinogen were significantly higher in observed group than in control group. The plasma antithrombin Ⅲ and coagulation factor Ⅱ were significantly lower in observed group than in control group. After treatment in 1 day,3 days and 7 days, pH,PaO2 were increased,PaCO2 was decreased and hypercoagulability state was improved. Conclusion The patients with chronic respiration failure were in hypercoagulability state. Hypoxemia and hypereapnia were connected with high coagulation. The anti - coagulability medicine treatment might benefit patients with chronic respiratory failure patients.