重症肺炎患者部分血栓前凝血及纤溶系统变化检测及临床意义

摘要

Objective To investigate the changes of coagulation and fibrinolysis system in patients with severe pneumonia and to analyze its clinical significance. Methods 60 patients with severe pneumonia were selected as the study group, and 60 healthy people were selected as the control group. Peripheral venous blood was taken to detect blood cells ( PLT, WBC ), coagulation parameters ( PT, APTT, Fg ), and fibrinolytic parameters ( DD, FDP ) in the two groups. Results PLT was lower in the study group than in the control group. WBC, PT, APTT, Fg, DD positive rate, and FDP positive rate were significantly higher in the study group than in the control group ( P <0. 05 ). In the study group, the levels of PT, APTT and Fg were significant different in patients with varying thrombocytopenia degrees ( P<0. 05 ). The platelet level was negatively correlated with the levels of PT, APTT and Fg ( r = -0.408, -0.517, -0.452, P <0. 05 ). There were significant differences of PT, APTT and Fg in patients with different degree of leukocytosis ( P <0. 05 ). The level of WBC was positively correlated with the levels of PT, APTT and Fg ( r =0. 392 , 0. 533 , 0. 497 ; P <0. 05 ). Conclusion There exists a certain degree of dysfunction of coagulation and fibrinolysis in patients with severe pneumonia, and the clinical monitoring of the related indicators should be strengthened.%目的 探讨重症肺炎患者部分血栓前凝血及纤溶系统变化.方法 选择本院收治的重症肺炎患者60例为研究组,同期来院健康体检者60名为对照组,两组均抽外周静脉血,检测患者血细胞(PLT、WBC)、凝血指标(PT、APTT、Fg)、纤溶指标(D-D、FDP),并进行组间比较.结果 研究组PLT低于对照组,WBC、PT、APTT、Fg 明显高于对照组,D-D阳性率、FDP阳性率均高于对照组,两组间比较上述指标差异均有统计学意义(P<0.05);研究组不同程度血小板减少患者PT、APTT、Fg差异显著(P<0.05),血小板水平与PT、APTT、Fg呈明显负相关(r=-0.408、-0.517、-0.452,P<0.05);研究组不同程度WBC增多患者,PT、APTT、Fg差异显著(P<0.05),WBC水平与PT、APTT、Fg呈明显正相关(r=0.392、0.533、0.497,P<0.05).结论 重症肺炎患者存在一定程度的凝血及纤溶功能失调,临床应加强对该指标监测,在抗感染治疗的同时,调整凝血系统功能,对缓解重症病情有积极意义.