慢性阻塞性肺病急性加重期血浆纤维蛋白原水平的变化及临床意义

摘要

目的 探讨血浆纤维蛋白原(plasma fibrinogen,Fbg)水平在慢性阻塞性肺病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的变化及其临床意义.方法 随机选择2009年1月至2010年6月确诊的AECOPD住院患者(AECOPD组)和同期健康体检者(健康对照组)各43例,检测并比较AECOPD患者急性发作期、治疗缓解后及健康体检者血浆Fbg水平,同时检测并比较治疗前后动脉血气与肺功能相关指标,将AECOPD患者血浆Fbg水平相关的因素作直线相关分析.结果 AECOPD患者血浆Fbg水平治疗前高于治疗后,且均明显高于健康对照者(均P＜0.05)；与一秒钟用力呼气容积占用力肺活量的比值(the ratio of the forced expiratory volume in one second and the forced vital capacity,FEV1/FVC)、一秒钟用力呼气容积(forced expiratory volume in one second,FEV1)、动脉氧分压呈显著负相关(P＜0.05),与二氧化碳分压呈显著正相关(P＜0.05).结论 AECOPD患者血浆Fbg水平与病情严重程度具有密切相关性；检测血浆Fbg水平可反映AECOPD患者治疗效果.%Objective To discuss the changes of plasma fibrinogen ( Fbg) among patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its clinical significance. Methods Forty-three inpatients with AECOPD and 43 normal subjects served as control group had been enrolled randomly from January 2009 to June 2010. The values of plasma fibrinogen were detected and compared between AECOPD patients and controls. The comparison was also done before and after treatment for AECOPD patients. The values of arterial blood gas and pulmonary function were recorded and compared before and after treatment at the same time. Linear regression analysis was performed with correlation factors of plasma fibrinogen. Results The values of plasma fibrinogen in AECOPD patients were significantly higher than those in control group (P < 0.05) ,and those before treatment was significantly higher than those after treatment ( P < 0. 05). The level of plasma fibrinogen was negatively correlated with the ratio of the forced expiratory volume in one second and the forced vital capacity (FEVj/FVC) , forced expiratory volume in one second (FEV, ) and arterial oxygen pressure (P < 0. 05 ) ,and was positively correlated with partial pressure of carbon dioxide ( P < 0. 05 ). Conclusions The level of plasma fibrinogen is closely correlated with the pathogenetic condition of AECOPD. The detection of plasma fibrinogen can reflect the therapeutic efficacy of AECOPD.