Evaluation Value And Clinical Significance Of Different Coagulation Fibrinolysis Indexes In Patients With AECOPD

Objective:To analyze and compare the correlation between thromboelastography and routine coagulation function,inflammatory index and blood gas analysis of AECOPD patients during hospitalization.Methods:From August 2016 to January 2019,a retrospective cross-sectional study was carried out on 40 AECOPD patients admitted to the emergency department of Shanghai East Hospital or the emergency intensive care unit,including 23 males and 17 females,aged58-95,with an average age of（79.75 ± 10.26）years.General data,TEG,coagulation function,WBC,C-reactive protein,procalcitonin and arterial blood gas analysis were collected.In addition,20 cases of physical examination in our hospital were collected,and the above indexes were also tested.Pearson correlation coefficient was used to analyze the correlation between TEG and coagulation index,blood gas analysis,inflammatory index.Results:The R value of AECOPD patients were significantly lower than those of the healthy controls,and there were higher levels of MA,WBC,CRP and PCT（P < 0.05）.The K value of AECOPD patients was negatively correlated with FIB（r =-0.42）,positively correlated with APTT（r = 0.67）,TT（r = 0.49）;R value was positively correlated with APTT（r = 0.49）,α angle was positively correlated with FIB（r = 0.39）,and negatively correlated with APTT（r =-0.61）;Ma was positively correlated with FIB（r = 0.68）,andnegatively correlated with APTT（r =-0.60）and TT（r =-0.37）;Ci was positively correlated with FIB（r = 0.41）,and negatively correlated with APTT（r =-0.69）and TT（r =-0.37）.The difference was statistically significant（p< 0.05）.In addition,MA was positively correlated with CRP（r = 0.39）.The indexes of TEG were also correlated with the indexes of arterial blood gas analysis: K value was negatively correlated with p H value of arterial blood（r =-0.36）,positively correlated with Pa CO₂（r = 0.37）and Lac（r = 0.48）;R value was negatively correlated with p H value of arterial blood（r =-0.39）,positively correlated with Pa CO₂（r = 0.35）,and α angle was negatively correlated with lac level of arterial blood（r =-0.45）;MA was positively correlated with PaO₂（r = 0.33）and negatively correlated with lac（r =-0.42）;CI was positively correlated with arterial p H（r = 0.37）,negatively correlated with PaO₂（r =-0.37）and Lac（r =-0.41）,and the difference was statistically significant（p < 0.05）.Conclusion:he thromboelastography of patients with AECOPD has a certain correlation with coagulation parameters,C-reactive protein,and blood gas analysis indicators.Thromboelastography has practical implications for assessing coagulation,inflammation,and internal environmental conditions in patients with AECOPD.Objective:To observe the different severity of AECOPD patients blood coagulation and fibrinolysis markers change rule and its correlation with inflammation,blood gas index,.Methods:The data of 60 patients with acute attack of chronic obstructive pulmonary disease who were admitted to our hospital from May 2019 to December 2019 were collected.According to the severity of the disease,the patients were divided into group A,group B and group C.the relevant data of people who underwent physical examination in our hospital in the same period were collected.The indexes of coagulation-fibrinolysis function,inflammation and blood gas analysis were observed and compared in each group,and the correlation between each coagulation and fibrinolysis index and inflammation index,some blood gas analysis index and pulmonary function index was analyzed.Results:AECOPD patients compared with healthy controls have higher levels of TAT,PIC,DD,FDP and Pa CO₂,CRP,IL-6,and low PaO₂（p < 0.05）;Three groups of patients with TAT,PIC,t-PAIC,FIB,D-D level differences statistically significant（p < 0.05）,in which the group C TAT,PIC,t-PA-IC,FIB,D-D levels significantly higher in group A than group B（p < 0.05）;Three groups of CRP levels in patients with statistically significant difference（p < 0.05）,with group C compared with group A and group B CRP levels increased significantly;Three group of patients with PaO₂,Pa CO₂ differences statistically significant（p < 0.05）,with group C compared with group A and group B PaO₂ level declined obviously,Pa CO₂ level increased significantly（p < 0.05）;TAT and FEV1 / FVC,FEV % Mr Pred are negatively correlated（r = 0.364,0.257）;T-PAIC with EV1 / FVC,FEV % Mr Pred are negatively correlated（r = 0.324,0.392）,the positive correlation between CRP（r = 0.473）;D-D was positively related with IL-6（r= 0.537）,and negatively correlated with PaO₂（r = 0.374）,and Pa CO₂ were positively correlated（r = 0.257）,the results have statistical significance（p < 0.05）.Conclusion:Patients with AECOPD have hypercoagulable state and may be related to the development of the disease,leading to the deterioration of lung function.At the same time,coagulation fibrinolysis index is closely related to patients’ inflammatory level and ventilation function.Therefore,timely and accurate monitoring of coagulation fibrinolysis status in AECOPD patients has a positive role in diagnosis and treatment.