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AECOPD 患者的凝血功能障碍及其与感染和高碳酸血症的关系。

Coagulation dysfunction in patients with AECOPD and its relation to infection and hypercapnia.

机构信息

Department of Respiratory and Critical Care Medicine, Affiliated Provincial Hospital, Anhui Medical University, Hefei, China.

Department of Respiratory and Critical Care Medicine, Affiliated First Hospital, University of Science and Technology of China, Hefei, China.

出版信息

J Clin Lab Anal. 2021 Apr;35(4):e23733. doi: 10.1002/jcla.23733. Epub 2021 Mar 25.

Abstract

BACKGROUND

Patients with chronic obstructive pulmonary disease (COPD) often have coagulation abnormalities. However, the factors that lead to coagulation dysfunction in acute exacerbation of COPD (AECOPD) remain insufficiently explored. This study aimed to investigate the factors affecting coagulation status in patients with COPD and their influence on thrombosis.

METHODS

Data of COPD patients, including 135 cases in acute exacerbation stage and 44 cases in stable stage from Nov 2016 to Nov 2019 in our hospital, were collected. Healthy people (n = 135) were enrolled as the controls. The coagulation parameters, blood gas indexes and blood routine examination results were collected and analyzed.

RESULTS

White blood count (WBC), neutrophil count, neutrophil percentage (N%), platelet (PLT), prothrombin time (PT), international normalized ratio (INR), fibrinogen (FIB), and activated partial thromboplastin time (APTT) increased, plasma thrombin time (TT) decreased in AECOPD group compared with the control group. In AECOPD group, PT, APTT, and FIB were positively correlated with neutrophils and C-reaction protein levels. PT was positively correlated with PCO2 and negatively with pH. Thrombosis was observed in five acute exacerbation and three stable stage COPD patients.

CONCLUSIONS

Patients with AECOPD presented abnormal coagulation status, which was correlated to infection and hypercapnia and might be potentially the risk factor of thrombosis.

摘要

背景

慢性阻塞性肺疾病(COPD)患者常伴有凝血异常。然而,导致 COPD 急性加重(AECOPD)时凝血功能障碍的因素仍未得到充分探索。本研究旨在探讨影响 COPD 患者凝血状态的因素及其对血栓形成的影响。

方法

收集了我院 2016 年 11 月至 2019 年 11 月期间的 135 例急性加重期 COPD 患者和 44 例稳定期 COPD 患者的数据,同时纳入了 135 例健康人作为对照组。收集并分析了凝血参数、血气指标和血常规检查结果。

结果

与对照组相比,AECOPD 组的白细胞计数(WBC)、中性粒细胞计数、中性粒细胞百分比(N%)、血小板(PLT)、凝血酶原时间(PT)、国际标准化比值(INR)、纤维蛋白原(FIB)和活化部分凝血活酶时间(APTT)升高,血浆凝血酶时间(TT)降低。AECOPD 组中 PT、APTT 和 FIB 与中性粒细胞和 C 反应蛋白水平呈正相关。PT 与 PCO2 呈正相关,与 pH 值呈负相关。在 5 例急性加重期和 3 例稳定期 COPD 患者中观察到血栓形成。

结论

AECOPD 患者存在异常的凝血状态,与感染和高碳酸血症有关,可能是血栓形成的潜在危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8430/8059715/ace57632fffb/JCLA-35-e23733-g001.jpg

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