CAJ | 학술논문

目的：研究分析老年慢性肺源性心脏病（肺心病）急性加重期血浆D-二聚体、血液流变学、凝血功能、肺功能指标变化与老年肺心病患者病情严重程度的相关性。方法：分别选取我院2011年4月～2013年4月期间收治的56例老年慢性肺心病急性加重期患者（研究组），与56例老年慢阻肺急性加重期患者（对照组）为研究对象，对两组均采用综合治疗方法治疗，分析比较治疗前后两组的血浆D-二聚体、血液流变学、凝血功能三项肺功能指标。结果：在治疗之前老年肺心性急性加重期患者的全血黏度（高/低切还原黏度）、BNP、PaCO2以及D-二聚体水平、血浆黏度都处于较高水平，PaO2处于较低水平；并且全血黏度（高/低切还原黏度）和PaO2呈现负相关关系（r=-0.59，P=0.03）；而与PaCO2呈现正相关关系（r=0.58，P=0.04）。血浆BNP和全血黏度（高/低切还原黏度）、D-二聚体水平以及血浆粘度呈现出正相关关系（r=0.63，P=0.001）。在治疗后患者的血浆粘度、D-二聚体水平、BNP、PaCO2以及全血黏度（高/低切还原黏度）显著性降低，PaO2显著性提高，和治疗前相比差异明显，有统计学意义（t=5.63，P=0.02）。但各项指标的正相关、负相关关系和治疗前相同。此外，研究组和对照组相比，凝血功能（TT、APTT、PT）明显较短，但是治疗以后数值明显延长，治疗前后相比，差异显著，有统计学意义（t=6.13，P=0.01）。结论：血浆D-二聚体、血液流变学、凝血功能三项肺功能指标可作为评价老年肺心病患者疾病严重程度、疗效的参考指标。
목적：연구분석노년만성폐원성심장병（폐심병）급성가중기혈장D-이취체、혈액류변학、응혈공능、폐공능지표변화여노년폐심병환자병정엄중정도적상관성。방법：분별선취아원2011년4월～2013년4월기간수치적56례노년만성폐심병급성가중기환자（연구조），여56례노년만조폐급성가중기환자（대조조）위연구대상，대량조균채용종합치료방법치료，분석비교치료전후량조적혈장D-이취체、혈액류변학、응혈공능삼항폐공능지표。결과：재치료지전노년폐심성급성가중기환자적전혈점도（고/저절환원점도）、BNP、PaCO2이급D-이취체수평、혈장점도도처우교고수평，PaO2처우교저수평；병차전혈점도（고/저절환원점도）화PaO2정현부상관관계（r=-0.59，P=0.03）；이여PaCO2정현정상관관계（r=0.58，P=0.04）。혈장BNP화전혈점도（고/저절환원점도）、D-이취체수평이급혈장점도정현출정상관관계（r=0.63，P=0.001）。재치료후환자적혈장점도、D-이취체수평、BNP、PaCO2이급전혈점도（고/저절환원점도）현저성강저，PaO2현저성제고，화치료전상비차이명현，유통계학의의（t=5.63，P=0.02）。단각항지표적정상관、부상관관계화치료전상동。차외，연구조화대조조상비，응혈공능（TT、APTT、PT）명현교단，단시치료이후수치명현연장，치료전후상비，차이현저，유통계학의의（t=6.13，P=0.01）。결론：혈장D-이취체、혈액류변학、응혈공능삼항폐공능지표가작위평개노년폐심병환자질병엄중정도、료효적삼고지표。
Objective: To study the analysis of senile cor pulmonale with acute aggravating period of plasma D-dimer,hemorheology and blood clotting function,pulmonary function index change and the correlation between the severity of disease in elderly patients who suffered heart disease from lung disorders.Methods:Selected from April 2011 to April 2013 admitted during the period of 56 cases of elderly patients with acute aggravating period of chronic cor pulmonale (research group),and 56cases of senile copd patients with acute aggravating period (control group) as the research object,on two groups adopt comprehensive treatment method,comparing two groups before and after the treatment of plasma D-dimer,blood rheology,blood coagulation function three lung function index.Results:In the treatment of elderly patients with acute aggravating period of mind before the whole blood viscosity (high/low shear reduction viscosity),BNP,PaCO2 and D-dimer level at a higher level,plasma viscosity,PaO2 low level;And the whole blood viscosity (high/low shear reduction viscosity) and PaO2 negative correlation (r=0.59,P=0.03).With PaCO2 show positive correlation(r=0.58,P=0.58).Plasma BNP and whole blood viscosity (high/low shear reduction viscosity),D-dimer level and plasma viscosity showed positive correlation (r=0.63,P=0.63).After treatment in patients with blood viscosity,D-dimer level,the BNP,PaCO2 and whole blood viscosity (high/low shear reduction viscosity) significantly lower,PaO2 significantly increased,and the clear difference compared with before treatment,was statistically significant (t=5.63,P=5.63).But the indicators of positive correlation,negative correlation between before and treatment are the same.In addition,the team compared with control group,blood coagulation function (TT and APTT and PT) significantly shorter,numerical extended obviously,but after treatment compared before and after treatment,significant difference,was statistically significant (t=6.13,P=6.13).Conclusion:Plasma D-dimer,blood rheology,blood coagulation function three lung function index can be used as the severity of disease,curative effect evaluation of elderly patients who suffered heart disease from lung disorders.