文章摘要
梁雅雪,范晓云,江子丰,丁佩山,徐玉菲.止凝血功能对于慢性阻塞性肺疾病急性加重期合并肺动脉高压患者的临床意义[J].中国临床保健杂志,2019,22(2):200-204.
止凝血功能对于慢性阻塞性肺疾病急性加重期合并肺动脉高压患者的临床意义
The significance of blood coagulation function in AECOPD patients with pulmonary hypertension
投稿时间:2018-10-15  
DOI:10.3969/J.issn.1672-6790.2019.02.015
中文关键词: 肺疾病,慢性阻塞性  高血压,肺性  止血  诊断技术和方法
英文关键词: Pulmonary disease,chronic obstructive  Hypertension,pulmonary  Hemostasis  Diagnostic techniques and procedures 〖FL
基金项目:国家自然科学基金面上项目(U1803126);安徽省自然科学基金项目(1708085MH178);2016年高校学科(专业)拔尖人才学术资助重点项目(gxbjZD2016036)
作者单位E-mail
梁雅雪 安徽医科大学第一附属医院老年呼吸与危重症学科,合肥 230022 13956988552@126.com 
范晓云 安徽医科大学第一附属医院老年呼吸与危重症学科,合肥 230022 13956988552@126.com 
江子丰 安徽医科大学第一附属医院老年呼吸与危重症学科,合肥 230022 13956988552@126.com 
丁佩山 安徽医科大学第一附属医院老年呼吸与危重症学科,合肥 230022 13956988552@126.com 
徐玉菲 安徽医科大学第一附属医院老年呼吸与危重症学科,合肥 230022 13956988552@126.com 
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中文摘要:
      目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)患者止凝血功能相关指标的变化,及其与肺动脉压力的相关性。 方法 选取217例AECOPD患者,根据肺动脉收缩压(PASP)分为4组:肺动脉压正常组(PASP≤30 mm Hg)46例、轻度PH组(PASP为>30且≤50 mm Hg)63例、中度PH组(PASP 为>50且≤70 mm Hg)50例和重度PH组(PASP>70 mm Hg)58例,比较分析四组患者止凝血功能(血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、纤维蛋白原含量(FIB)、国际标准化比率(INR)、D-二聚体(D-Dimer)、纤维蛋白降解产物(FDP)、抗凝血酶-III(AT-III))。 结果 四组患者PT、APTT、INR、FIB、D-Dimer、FDP之间差异有统计学意义(P<0.05),TT、AT-III之间差异无统计学意义(P>0.05)。D-Dimer及FDP重度组均大于中度、轻度及正常组(P<0.05),PT、APTT及INR中、重度组均小于正常、轻度组(P<0.05)。FIB轻度、中度及重度组均大于正常组(P<0.05),重度组大于轻度组(P<0.05)及中度组(P=0.05),余各组之间差异均无统计学意义(P>0.05)。四组患者PT、APTT、INR与PASP之间呈负相关,FIB、D-Dimer、FDP与PASP之间均呈正相关。此外,感受性曲线(ROC)分析提示:FIB指标曲线下面积最大,为0.718(P<0.05,95%CI:0.625~0.810),对应诊断界点值3.36 g/L。 结论 监测PT、APTT、INR、FIB、D-Dimer、FDP等指标对评估AECOPD患者病情及合并症具有重要价值,其中FIB准确性及灵敏度较高,FIB大于3.36 g/L时,AECOPD患者尤其是合并肺动脉高压的患者存在血液高凝的风险越大。
英文摘要:
      Objective To determine the blood coagulation function in AECOPD patients with pulmonary hypertension (PH) to explore its correlation with the pulmonary arterial pressure. Methods The clinical data of 217 AECOPD patients were retrospectively analyzed,and they were divided into four groups according to pulmonary artery systolic pressure (PASP):the normal group (PASP≤30 mm Hg) with 46 cases,the mild PH group (>30 & ≤50 mm Hg) with 63 cases,the moderate PH group(>50 & ≤70 mm Hg) with 50 cases and the severe PH group(PASP>70 mm Hg) with 58 cases.Then the blood coagulation(PT,APTT,TT,FIB,INR,D-Dimer,FDP,AT-III)was analyzed in all the selected patients. Results The average serum PT,APTT,INR,FIB,D-Dimer and FDP had differences (P<0.05) in the patients among four groups,but there was no significant difference in TT and AT-III (P>0.05).The D-Dimer and FDP in severe group was higer than those in moderate,mild and normal group (P<0.05),for PT,APTT and INR,the moderate and severe group were both less than the normal and mild group (P<0.05).And for FIB the mild,moderate and severe group were all higher than the normal group (P<0.05),and the severe was higher than the mild (P<0.05) and moderate group (P=0.05).While there was no significant difference for these indicators between the left groups(P>0.05).Among the four groups PT,APTT and INR decreased with the increase of PASP,while FIB,D-Dimer and FDP increased.Besides,it indicates that the area of FIB under ROC curve is the highest with 0.718 (P<0.05,95%CI:0.625-0.810) and the cut-off is 3.36 g/L. Conclusion Detecting PT,APTT,INR,FIB,D-Dimer and FDP has important value to evaluate the states and complications of AECOPD patients,meanwhile the accuracy and sensitivity of FIB are higher than the others,so it has a certain guiding significance.
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