Stanford A型主动脉夹层对凝血功能的影响

目的 探讨Stanford型主动脉夹层患者凝血功能的变化及其临床意义.方法 以2003年3月至2011年1月新疆维吾尔自治区人民医院心外科收治Stanford A型主动脉夹层114例为主动脉夹层组,选性别与年龄匹配的体检健康者95例为正常对照组,全自动血凝分析仪检测国际化标准比值(INR)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和凝血酶时间(TT)、D-二 聚体.结果 主动脉夹层组INR、APTT、FIB、D-二聚体均高于正常对照组分别为1.11比1.02,(3.86±1.87)比(2.45±0.74),( 37.62±8.43)比(32.39±36.44),(5.78±6.63)比(0.14±0.12)],TT低于对照组(15.70比19.75),P＜0.01.亚急性及慢性组夹层组(36例)FIB高于急性夹层组(78例)(5.04±1.84)比(3.29±1.61)],D-二.聚体低于急性夹层组(2.21±1.67)比(6.67±7.12)].结论 Stanford A型主动脉夹层在凝血与纤溶被激活的同时伴有纤溶受抑,凝血与纤溶间的平衡被破坏而产生高凝状态.

The influence of type A aortic dissection on coagulation function

Objective To explore the changes of blood coagulation function and clinical significances in type A aortic dissection (AD).Methods One hundred and fourteen patients with type A aortic dissection group and 95 persons in healthy control group were selected respectively(NC).Analysis of international normalized ratio (INR),activated partial thromboplastin time (APTT ),thrombin time(TT ),fibrinogen (FIB)and D-dimer (DD)were conducted.Results INR,APTT,FIB,DD in AD group significiantly increased compared with NC group (1.11,3.86 ±1.87,37.62 ±8.43,5.78 ±6.63) ;(1.02,2.45 ±0.74,32.39 ±36.44,0.14 ±0.12)],TT decreased respectively 15.70 ; 19.75 ] ( P ＜ 0.01 ).Subact and chronic aortic dissection showed a significant increase in FIB (5.04 ± 1.84) vs ( 3.29 ± 1.61 ) ],decrease in DD compared with acute group ( 2.21 ± 1.67 ) vs (6.67 ±7.12) ],P ＜0.01.Conclusion AD is characterized by activation of both coagulation and fibrinolysis,together with inhibition of fibrino lysis,resulting in an imbalance between coagulation and fibrinolysis leading to a hypercoagulation state.