老年肺心病患者血浆D-二聚体等纤溶指标的测定及临床意义

目的:分析老年慢性肺心病患者不同病理状态的血浆D-二聚体(D-D)等纤溶指标变化及临床意义。方法:对42例急性加重期、8例恶化期及16例缓解期患者和20例健康对照组血浆D-D及其它纤溶指标分别进行测定。结果:血浆D-D水平在急性加重期患者明显升高(与对照组比较,P<0.01);恶化期患者升高更为明显,其它纤溶指标在肺心病各组均下降;D-D及纤溶指标均与PCO2呈正相关;吸烟可降低纤溶活性。结论:血浆纤溶活性降低与老年肺心病患者的高凝状态及并发肺梗塞和DIC有关。肺心病患者应戒烟并提示临床考虑应用促纤溶药物治疗。

Variance of Plasma D-D and Other Indicators of Fibrinolysis in Elderly Patients with Pulmonary Heart Disease and Its Clinical Sighificance

Objective:To analysis the elderly patients with pulmonary heart disease in different pathological state of plasma D-D and other indicators of changes in fibrinolysis and its clinical significance.Method:The plasma D-D and other indicators of fibrinolysis of the 42 cases of acute exacerbation,8 cases of deterioration period and 16 cases of deterioration in remission patients and 20 cases of healthy control group were measured.Results:Plasma D-D levels of the patients with acute exacerbation increased significantly(compared with the control group,P<0.01).In particular plasma D-D levels of the patients with deterioration increased more obviously,other indicators of fibrinolysis in each group were declined.D-D and fibrinolytic indicators are positively correlated with PCO2.Smoking can reduce fibrinolytic activity.Conclusion:Lower plasma fibrinolytic activity and the hypercoagulable state of the elderly patients with pulmonary heart disease and pulmonary infarction are related with DIC.Patients with pulmonary heart disease should quit smoking and it schould be suggested that promoting fibrinolytic drugs could be clinical used.