摘要
目的探讨血浆D-二聚体、X因子和组织因子在慢性阻塞性肺疾病急性加重期（AECOPD）的变化及其临床意义，并进一步分析AECOPD合并深静脉血栓（DVT）时上述指标的改变。方法研究对象为2007年3月至2009年9月收治的资料完整的AECOPD患者56例（AECOPD组），其中合并DVT及未合并DVT者各28例；选取同期性别、年龄与之匹配的健康体检者60名作为健康对照组。分别抽取静脉血2．7ml，检测血浆中D-二聚体、x因子及组织因子水平，并对检测结果进行统计学分析。结果两组在性别、年龄分布上差异均无统计学意义，具有可比性；AECOPD组中合并与未合并DVT者在性别、年龄分布上差异均无统计学意义，也具有可比性。AECOPD组血浆D-二聚体水平为（0．76±0．30）mg／L，明显高于健康对照组的（0．29±0．11）mg／L，P〈0．01；AECOPD组中合并DVT者血浆D-二聚体水平为（0．85±0．29）mg／L，明显高于未合并DVT者（0．67±0．28）mg／L的水平，P〈0．05。AECOPD组血浆组织因子和x因子水平分别为（238±68）mg／L和（1181±337）mg／L，与健康对照组的（124±30）mg／L和（998±260）mg／L比较，差异均有统计学意义（均P〈0．01）；AECOPD组中合并与未合并DVT者比较，组织因子和x因子水平差异均无统计学意义（均P〉0．05）。结论AECOPD患者存在血液高凝状态，而血浆中D-二聚体水平明显升高者提示可能合并DVT。
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-di
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第22期1543-1545,共3页
National Medical Journal of China
基金
国家科技支撑计划课题（2006BAl01A06）
中华医学会临床医学科研项目（07010460054）
关键词
肺疾病
慢性阻塞性
静脉血栓形成
纤维蛋白溶解
诊断
Pulmonary disease, chronic obstructive
Venous thrombosis
Fibrinolysis
Diagnosis
