天津医药

• 论著 •    

慢性阻塞性肺疾病患者D-二聚体和抗凝血酶III的水平及与预后关系

俞绮虹1,李月川2   

  1. 1. 天津市胸科医院胸内科
    2. 天津市胸科医院
  • 收稿日期:2009-07-28 修回日期:2010-01-12 出版日期:2010-05-15 发布日期:2010-05-15
  • 通讯作者: 俞绮虹

The changes of plasma DD and ATШ levels in patients with acute exacerbations of COPD and their relationship with the outcome of the disease

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  • Received:2009-07-28 Revised:2010-01-12 Published:2010-05-15 Online:2010-05-15

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摘要： 摘要 目的：观察慢性阻塞性肺疾病急性加重期（AECOPD）外周血D二聚体（DD）和抗凝血酶III（ATIII）的变化及其与预后的关系。方法：AECOPD患者入院时、治疗后7天分别取血测定血浆凝血纤溶指标，包括DD、ATIII水平，与健康对照者比较，并将AECOPD分为改善组和恶化组，采用自身前后对照法比较治疗前后DD、ATIII水平的变化。结果：38例AECOPD患者入院时DD为（0.98±0.80）mg/L，较对照组升高（P<0.01），ATIII为（77.92±12.61）%，较对照组降低（P<0.01）；改善组治疗后DD由（1.07±0.83）mg/L 降为（0.62±0.42）mg/L ；ATIII由（78.20±12.30）%升为（87.69±8.34）%，而恶化组治疗后DD由（0.82±0.76）mg/L 升为（1.95±1.30）mg/L ，ATIII由（77.38±13.67）%降为（71.38±10.44）%，恶化组治疗后DD较改善组升高（P<0.01），ATIII较改善组降低（P<0.01）。结论：AECOPD患者DD水平升高，ATIII降低；DD和ATIII水平与病情严重程度相关，其变化可作为AECOPD病情严重程度和疗效的指标，与AECOPD预后相关。

关键词: 肺疾病, 慢性阻塞性, D二聚体, 抗凝血酶III, 预后

Abstract: Objective The purpose of this article was to investigate the changes in D-dimer(DD) and AntithrombinШ(ATШ) and their relationship with the outcome in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods The plasma levels of ATШ and DD were measured in patients with AECOPD before and after 7 days of treatment, and in control subjects. The patients were divided into recover group and worsen group. The plasma levels of ATШ and DD were also compared in the two groups. Results In 38 patients of AECOPD，the level of DD was （0.98±0.80）mg/L，which is significantly higher than in control subjects；ATШ was （77.92±12.61）%，which is significantly lower than in control subjects（P<0.01）. In recover group，the levels of DD decrease from（1.07±0.83）mg/L to（0.62±0.42）mg/L and ATШ increase from （78.20±12.30）% to（87.69±8.34）% with the disease；In worsen group ，DD increase from（0.82±0.76）mg/L to（1.95±1.30）mg/L and ATШ decrease from （77.38±13.67）% to（71.38±10.44）%（P<0.01）. Conclusion The levels of DD increase and ATШ decrease significantly during AECOPD. They are relative with the severity of the disease. The alternation of ATШ and DD may be a useful index in evaluation the severity of the disease and effect of therapy. They are relative with the outcome of AECOPD.