Analysis in changs of coagulation function indexes in chronic obstructive pulmonary disease patients complicated with community-acquired pneumonia
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摘要: 目的 探讨慢性阻塞性肺疾病(COPD)合并社区获得性肺炎(CAP)患者凝血功能指标的变化。 方法 回顾性分析81例COPD合并CAP患者相关指标,另选取同期本科室收治的慢性阻塞性肺疾病急性加重期(AECOPD)患者(n=135)、CAP患者(n=136)及健康体检者(n=136)作为对照。比较各组炎症指标、血气分析指标的差异。 结果 各组患者的白细胞计数、中性粒细胞计数、中性粒细胞百分比、血小板、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-D)等指标比较,差异有统计学意义(P<0.05或P<0.01)。多元相关性分析显示, COPD合并CAP组患者白细胞计数、中性粒细胞计数与D-D呈显著正相关(r=0.362、0.351, P=0.001、0.001), 动脉血氧分压［p(O2)］与D-D呈显著负相关(r=-0.267, P=0.017), 中性粒细胞百分比、pH值、动脉血二氧化碳分压［p(CO2)］与D-D无显著相关性(r=0.165、-0.040、0.105, P=0.162、0.694、0.349)。通过多元线性回归分析建立回归方程,将白细胞计数及p(O2)引入回归方程,发现白细胞计数对D-D的作用大于p(O2)对D-D的作用。 结论 炎症反应和低氧血症均可能对凝血功能产生影响,其中炎症反应对凝血功能的影响较低氧血症的可能更大。Abstract: Objective To investigate the changes of coagulation function indexes in patients with chronic obstructive pulmonary disease(COPD)and community-acquired pneumonia(CAP). Methods Clinical indexes of 81 COPD patients with CAP were analyzed retrospectively. In addition, the patients(n=135)with acute exacerbation of chronic obstructive pulmonary disease(AECOPD), and those with CAP(n=136)and healthy people(n=136)were selected as the controls. The differences of inflammation indexes and blood gas indexes were compared among groups. Results There were significant differences in white blood cell count, neutrophil count, neutrophil percentage, platelet, prothrombin time(PT), fibrinogen(FIB), thrombin time(TT)and D-Dimer(D-D)among groups(P<0.05 or P<0.01). In the COPD complicated with CAP group, the multiple correlation analysis showed that white blood cell count and neutrophil count were positively correlated with D-D(r=0.362, 0.351, P=0.001, 0.001), arterial oxygen partial pressure ［p(O2)］ was negatively correlated with D-D(r=-0.267, P=0.017), but neutrophil percentage, pH value, arterial carbon dioxide partial pressure ［p(CO2)］ were not correlated with D-D(r=0.165, -0.040, 0.105, P=0.162, 0.694, 0.349). White blood cell count and p(O2)were introduced into the regression equation established on the basis of multiple linear regression analysis, and the result showed - that the effect of white blood cell count on D-D was greater than that of p(O2). Conclusion Both inflammatory reaction and hypoxia may have effect on coagulation function, and the effect of inflammatory reaction on coagulation function may be greater than that of hypoxia.
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