凝血纤溶系统失衡与肺间质纤维化合并呼吸衰竭患者炎性指标相关性分析

doi:10.3969/j.issn.1006-6233.2024.05.026

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摘要 目的: 探讨凝血纤溶系统失衡与肺间质纤维化(Idiopathic pulmonary fibrosis,IPF)合并呼吸衰竭(Respiratory failure,RF)患者炎性指标相关性。方法: 选择我院2020年10月至2023年12月IPF患者98例,依据是否合并RF分为RF组(n=42)与无RF组(n=56)。采用全自动凝血分析仪测定活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、凝血酶原时间(prothrombin time,PT)和纤维蛋白原(fibrinogen,FIB)水平,免疫比浊法测定D-二聚体(D-Dimer,D-D)水平;全自动血细胞分析仪测定中性粒细胞百分比(Neutrophil percentage,NEUT)和白细胞计数(white blood cell count,WBC),酶联免疫吸附法测定C反应蛋白(C-reactive protein,CRP)水平,放射免疫分析法测定降钙素原(Procalcitonin,PCT)水平。比较两组凝血纤溶指标和炎性指标水平变化;采用Pearson分析凝血纤溶指标与炎性指标相关性;分析凝血纤溶指标和炎性指标与IPF合并RF关系。结果: RF组APTT、TT和PT低于无RF组,而FIB和D-D高于无RF组,差异均有统计学意义(P<0.05)。RF组NEUT、WBC、CRP和PCT水平高于无RF组,差异均有统计学意义(P<0.05)。经Pearson分析,APTT、TT和PT与NEUT、WBC、CRP和PCT呈线性负相关,而FIB和D-D与NEUT、WBC、CRP和PCT呈线性正相关(P<0.05)。APTT、TT、PT、FIB、D-D、NEUT、WBC、CRP和PCT为影响IPF合并RF危险因素。结论: IPF合并RF患者存在凝血纤溶系统失衡和炎性反应,且凝血纤溶系统失衡与炎性指标变化密切相关,值得临床借鉴。

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	王莹莹
	顾东伟
	郑磊

关键词 ：凝血纤溶系统, 肺间质纤维化, 呼吸衰竭, 炎性指标

Abstract：Objective: To investigate the correlation between coagulation and fibrinolysis imbalance and inflammatory indicators in patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure (RF). Methods: A total of 98 patients with IPF treated in our hospital from October 2020 to December 2023 were selected and divided into RF group (n=42) and non-RF group (n=56) based on whether they had RF. An automated coagulation analyzer was used to measure activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), and fibrinogen (FIB) levels; D-dimer (D-D) level was measured by immunoturbidimetry; neutrophil percentage (NEUT) and white blood cell count (WBC) were measured by automated blood cell analyzer; C-reactive protein (CRP) level was measured by enzyme-linked immunosorbent assay (ELISA); and procalcitonin (PCT) level was measured by radioimmunoassay. The levels of coagulation and fibrinolysis indicators and inflammatory indicators in the two groups were compared; Pearson correlation analysis was used to analyze the correlation between coagulation and fibrinolysis indicators and inflammatory indicators; and the relationship between coagulation and fibrinolysis indicators and inflammatory indicators and IPF combined with RF was analyzed. Results: APTT, TT, and PT were lower in the RF group than in the non-RF group, while FIB and D-D were higher in the RF group than in the non-RF group, and the differences were statistically significant (P<0.05). NEUT, WBC, CRP, and PCT levels were higher in the RF group than in the non-RF group, and the differences were statistically significant (P<0.05). Pearson correlation analysis showed that APTT, TT, and PT were negatively correlated with NEUT, WBC, CRP, and PCT, while FIB and D-D were positively correlated with NEUT, WBC, CRP, and PCT (P<0.05). APTT, TT, PT, FIB, D-D, NEUT, WBC, CRP and PCT were risk factors for IPF combined with RF. Conclusion: Patients with IPF combined with RF have coagulation and fibrinolysis imbalance and inflammatory response, and coagulation and fibrinolysis imbalance is closely related to the changes in inflammatory indicators, which is worthy of clinical reference.

Key words： Coagulation and fibrinolysis system Idiopathic pulmonary interstitial fibrosis Respiratory failure Inflammatory indicators

基金资助:安徽省卫生健康委2021年度科研立项课题,(编号:20210342)

引用本文:

王莹莹, 顾东伟, 郑磊. 凝血纤溶系统失衡与肺间质纤维化合并呼吸衰竭患者炎性指标相关性分析[J]. 河北医学, 2024, 30(5): 844-848.
WANG Yingying, GU Dongwei, ZHENG Lei. Analysis of the Correlation between Coagulation and Fibrinolysis Imbalance and Inflammatory Indicators in Patients with Idiopathic Pulmonary Fibrosis and Respiratory Failure. HeBei Med, 2024, 30(5): 844-848.

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