[慢性阻塞性肺疾病急性加重期凝血功能的变化及其意义]

[Change of coagulation functions and its significance in acute exacerbation of chronic obstructive pulmonary disease].

作者信息

Huang Xiu-xia, Pang Bao-sen, Yang Yuan-hua, Zhang Hai-yan, Guo Su-liang

机构信息

Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Jun 14;91(22):1543-5.

PMID:21914367

Abstract

OBJECTIVE

To explore the changes and clinical significances of plasma D-dimer, factor X and tissue factor in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the in-depth changes of these indicators in AECOPD with co-current deep venous thrombosis (DVT).

METHODS

A total of 56 AECOPD patients were divided into the DVT and non-DVT subgroups (n = 28 each). And 60 normal control subjects were recruited according to age and gender. For each subject, 2.7 ml whole blood was drawn and then the plasma levels of D-dimer, factor X and tissue factor were detected. The results were statistically analyzed with the software SPSS 13.0. And the analysis of variance was performed between the groups.

RESULTS

There was no significant difference between the distribution of the AECOPD group and the control group by gender and age. Therefore two groups were comparable. And in the AECOPD group, there was no significant difference between the distribution of DVT and non-DVT subgroups by gender and age. Therefore these two subgroups were comparable as well. The value of D-dimer in the AECOPD patients was significantly higher than that in the normal control [(0.76 ± 0.30) vs (0.29 ± 0.11) mg/L, P < 0.01]; and in the AECOPD group, the value of D-dimer in the DVT subgroup was significantly higher than that in the non-DVT subgroup [(0.85 ± 0.29) vs (0.67 ± 0.28) mg/L, P < 0.05]. In the AECOPD group, the value of tissue factor was (238 ± 68) mg/L and the value of factor X (1181 ± 337) mg/L. While in the normal control group, the values were (124 ± 30) and (998 ± 260) mg/L respectively. As for tissue factor and factor X, there were significant differences between two groups (all P < 0.01). Yet in AECOPD patients, neither indicator had significant differences between the DVT and non-DVT subgroups (all P > 0.05).

CONCLUSION

The blood of AECOPD patients is in a hypercoagulatory state. And an obvious rise in their plasma level of D-dimer suggests that it may be complicated with DVT.

摘要

目的

探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者血浆D-二聚体、因子X及组织因子的变化及其临床意义，并分析合并并发深静脉血栓形成（DVT）的AECOPD患者上述指标的变化情况。

方法

选取56例AECOPD患者，分为DVT组和非DVT组，每组28例。另根据年龄、性别选取60例正常对照者。采集每位研究对象2.7 ml全血，检测血浆D-二聚体、因子X及组织因子水平。采用SPSS 13.0软件进行统计学分析，组间比较采用方差分析。

结果

AECOPD组与对照组在性别、年龄分布上差异无统计学意义，具有可比性。AECOPD组中，DVT组与非DVT组在性别、年龄分布上差异无统计学意义，具有可比性。AECOPD患者血浆D-二聚体水平显著高于正常对照组[（0.76±0.30）比（0.29±0.11）mg/L，P<0.01]；AECOPD组中，DVT组血浆D-二聚体水平显著高于非DVT组[（0.85±0.29）比（0.67±0.28）mg/L，P<0.05]。AECOPD组组织因子水平为（238±68）mg/L，因子X水平为（1181±337）mg/L；正常对照组组织因子水平为（124±30）mg/L，因子X水平为（998±260）mg/L。两组组织因子及因子X水平比较差异均有统计学意义（均P<0.01）。但在AECOPD患者中，DVT组与非DVT组上述指标差异均无统计学意义（均P>0.05）。