慢性阻塞性肺疾病急性发作期合并糖尿病病人血流变指标及凝血纤溶功能的变化
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摘要
目的:探讨慢性阻塞性肺疾病急性发作期(AECOPD)合并糖尿病病人的血流变指标及凝血纤溶功能的变化。方法:研究纳入52例AECOPD合并糖尿病病人(观察组),50例单纯AECOPD病人(对照组)和40名健康人(正常组),测定血流变指标、凝血四项、抗凝血酶Ⅲ、D-二聚体(D-D)和纤维蛋白原降解产物(FDP)。结果:对照组和观察组的全血黏度、血浆黏度、血细胞比容和红细胞沉降率增高均显著高于正常组(P<0.01);观察组各项血流变指标均显著高于对照组(P<0.01)。对照组和观察组凝血纤溶功能凝血酶凝固时间、凝血酶原时间、部分凝血活酶时间显著小于正常组(P<0.01),纤维蛋白原、抗凝血酶Ⅲ、D-D、FDP均显著高于正常组(P<0.01);观察组纤维蛋白原、D-D、FDP显著高于对照组(P<0.01),凝血酶凝固时间显著小于对照组(P<0.05)。结论:AECOPD合并糖尿病病人的血流变指标及凝血纤溶功能存在明显异常。
Objective: To explore the changes of hemorheology and coagulation fibrinolysis function in acute episode chronic occlusive pulmonary disease( AECOPD) patients complicated with diabetes mellitus. Methods: Fifty-two AECOPD patients complicated with diabetes mellitus,50 AECOPD patients and 40 healthy people were divided into the observation group,control group and normal group,respectively. The hemorheology indexes,four routine coagulation indexes,antithrombin-Ⅲ( AT-Ⅲ),D dimer( D-D) and fibrinogen degradation products( FDP) in three groups were detected. Results: The levels of whole blood viscosity,plasm viscosity,hematocrit and erythrocyte sedimentation rate in control group and observation group were significantly higher than those in normal group( P < 0. 01).The hemorheology indexes in observation group were significantly higher than that in control group( P < 0. 01). The coagulase coagulation time,prothrombin time and partial thrombin time in control group and observation group were significantly less than those in normal group( P < 0. 01),and the levels of fibrinogen,D-D and FDP in observation group were significantly higher than those in control group( P < 0. 01),and the coagulase coagulation time in observation group was significantly less than that in normal group( P < 0. 05).Conclusions: The hemorheology,and coagulation fibrinolysis function in AECOPD patients complicated with diabetes mellitus are obviously abnormal.
Objective: To explore the changes of hemorheology and coagulation fibrinolysis function in acute episode chronic occlusive pulmonary disease( AECOPD) patients complicated with diabetes mellitus. Methods: Fifty-two AECOPD patients complicated with diabetes mellitus,50 AECOPD patients and 40 healthy people were divided into the observation group,control group and normal group,respectively. The hemorheology indexes,four routine coagulation indexes,antithrombin-Ⅲ( AT-Ⅲ),D dimer( D-D) and fibrinogen degradation products( FDP) in three groups were detected. Results: The levels of whole blood viscosity,plasm viscosity,hematocrit and erythrocyte sedimentation rate in control group and observation group were significantly higher than those in normal group( P < 0. 01).The hemorheology indexes in observation group were significantly higher than that in control group( P < 0. 01). The coagulase coagulation time,prothrombin time and partial thrombin time in control group and observation group were significantly less than those in normal group( P < 0. 01),and the levels of fibrinogen,D-D and FDP in observation group were significantly higher than those in control group( P < 0. 01),and the coagulase coagulation time in observation group was significantly less than that in normal group( P < 0. 05).Conclusions: The hemorheology,and coagulation fibrinolysis function in AECOPD patients complicated with diabetes mellitus are obviously abnormal.
引文
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[11]LIU BH,SUN MX,ZHOU N,et al.Detection and study of plasma D-dimer change in patients with acute exacerbation of chronic obstructive pulmonary disease[J].J Biol Regul Homeost Agents,2016,30(3):839.
[12]ALLINGSTRUP M,WETTERSLEV J,RAVN FB,et al.AntithrombinⅢfor critically ill patients:a systematic review with meta-analysis and trial sequential analysis[J].Intensive Care Med,2016,42(4):505.
[13]CORBAN MT,HUNG OY,MEKONNEN G,et al.Elevated levels of serum fibrin and fibrinogen degradation products are independent predictors of larger coronary plaques and greater plaque necrotic core[J].Circ J,2016,80(4):931.
[14]SHI X,LI H.Anticoagulation therapy in patients with chronic obstructive pulmonary disease in the acute exacerbation stage[J].Exp Ther Med,2013,5(5):1367.
[2]KOSKELA HO,SALONEN PH,NISKANEN L.Hyperglycaemia during exacerbations of asthma and chronic obstructive pulmonary disease[J].Clin Respir J,2013,7(4):382.
[3]张卫娟,王啸澜.中老年糖尿病患者低血糖知识认知水平及昏迷的相关因素[J].中国医师杂志,2016,18(6):922﹒
[4]李华,冯振东,叶树新,等.2型糖尿病患者血液流变学指标与血糖监测指标的相关性分析[J].中国全科医学,2013,16(5C):1763﹒
[5]LI Y,TIAN XX,LIU T,et al.Association between whole blood viscosity and arterial stiffness in patients with type 2 diabetes mellitus[J].Endocrine,2015,49(1):148.
[6]KOSKELA HO,SALONEN PH,ROMPPANEN J,et al.A history of diabetes but not hyperglycaemia during exacerbation of obstructive lung disease has impact on long-term mortality:a prospective,observational cohort study[J].BMJ Open,2015,5(1):e006794.
[7]张世茹,苏卫华,徐红艳,等.慢性阻塞性肺疾病急性发作期合并糖尿病患者的血栓前状态及抗凝治疗[J].山西医科大学学报,2010,41(7):632﹒
[8]林武洲,李浪波,陈梅唏,等.慢性阻塞性肺疾病合并2型糖尿病患者凝血、纤溶功能的变化[J].中国实验诊断学,2013,17(5):942﹒
[9]赵瑞,吴宇晗,邵玉霞.慢性阻塞性肺疾病与糖尿病相关性的研究进展[J].临床肺科杂志,2016,21(10):1900﹒
[10]SAPKOTA B,SHRESTHA SK,POUDEL S.Association of activated partial thromboplastin time and fibrinogen level in patients with typeⅡdiabetes mellitus[J].BMC Res Notes,2013,6:485.
[11]LIU BH,SUN MX,ZHOU N,et al.Detection and study of plasma D-dimer change in patients with acute exacerbation of chronic obstructive pulmonary disease[J].J Biol Regul Homeost Agents,2016,30(3):839.
[12]ALLINGSTRUP M,WETTERSLEV J,RAVN FB,et al.AntithrombinⅢfor critically ill patients:a systematic review with meta-analysis and trial sequential analysis[J].Intensive Care Med,2016,42(4):505.
[13]CORBAN MT,HUNG OY,MEKONNEN G,et al.Elevated levels of serum fibrin and fibrinogen degradation products are independent predictors of larger coronary plaques and greater plaque necrotic core[J].Circ J,2016,80(4):931.
[14]SHI X,LI H.Anticoagulation therapy in patients with chronic obstructive pulmonary disease in the acute exacerbation stage[J].Exp Ther Med,2013,5(5):1367.