兰州大学机构库 >学院待认领
慢性阻塞性肺疾病患者凝血功能异常与氧化应激关系研究
Alternative TitleA study of the relationship between coagulation/anticoagulation imbalance and oxidative stress in the patients with chronic obstructive pulmonary disease
黄瑾
Thesis Advisor刘晓菊
2011-05-17
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword慢性阻塞性肺疾病 组织因子 组织因子途径抑制剂 氧化应激 总抗氧化能力 丙二醛 谷胱甘肽过氧化物酶 肺功能 动脉血氧分压 动脉血氧饱和度
Abstract目的 观察慢性阻塞性肺疾病急性加重(AECOPD)患者治疗前后血浆组织因子(TF)活性、组织因子途径抑制剂(TFPI)活性以及其比值TF/TFPI的改变及氧化应激状态;探讨AECOPD患者在正规治疗前后凝血功能的改变与氧化应激之间的关系。 方法 对28名AECOPD患者(实验组)治疗前后及30名健康体检者(对照组)采用底物发色法检测血浆TF活性及TFPI活性;菲罗啉比色法检测血浆总抗氧化能力(TAC);硫代巴比妥酸比色法检测血浆丙二醛(MDA)含量;改良Hafeman直接测定法(DNTB)检测血浆谷胱甘肽过氧化物酶(GSH-PX)活力;采用散射比浊法检测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB);同时对实验组治疗前后均进行肺功能检测、动脉血气分析及功能性呼吸困难评分(MMRC)。 结果 1. 呼吸功能相关指标:1.1 AECOPD患者治疗前肺功能[FEV1%(40.64±17.14)%、FEV1/FVC%(47.09±11.55)%]明显低于治疗后[FEV1%(52.16±24.07)%、FEV1/FVC%(53.93±13.66)%](P均<0.05),但均明显低于健康对照组[FEV1%(104.10±14.73)%、FEV1/FVC%(81.03±7.00)%](P均<0.01)。1.2 AECOPD患者治疗前PaO2 和SaO2%[(47.32±8.81)mmHg、(81.54±10.83)%]明显低于治疗后[(55.48±7.11)mmHg、(88.61±4.10)%](P均<0.01),但治疗前PaCO2(41.89±8.76)mmHg与治疗后(41.17±8.73)mmHg无明显差异(P>0.05)。1.3 AECOPD患者治疗前中性粒细胞百分比(69.05±10.80)%明显高于治疗后(61.67±8.33)%及健康对照组(58.12±7.26)%(P<0.01或P<0.05),但AECOPD患者治疗后及健康对照组之间中性粒细胞百分比无明显差异。1.4 AECOPD患者治疗前呼吸困难评分(MMRC)(2.86±0.45)明显高于治疗后(1.43±0.50)(P<0.01)。 2. 凝血功能相关指标:2.1 AECOPD患者治疗前血浆TF活性(139.32±81.93)pmol/L明显高于治疗后(36.35±14.94)pmol/L(P<0.01),经治疗后均明显下降,但仍显著高于健康对照组(3.34±3.26)pmol/L(P均<0.01)。2.2 AECOPD患者治疗前血浆TFPI活性(0.11±0.02)U/ml明显高于治疗后(0.09±0.01)U/ml(P<0.01),经治疗后均明显下降,但仍显著高于健康对照组(0.06±0.01)U/ml(P均<0.01)。2.3 AECOPD患者治疗前血浆TF/TFPI(1204.52±531.06)明显高于治疗后(399.93±130.35)(P<0.01),经治疗后均明显下降,但仍显著高于健康对照组(52.70±48.15)(P均<0.01)。2.4 AECOPD患者治疗前血浆PT、APTT、FIB[(15.13±4.64)s、(31.61±9.45)s、(5.09±2.05)g/L]与治疗后血浆PT、APTT、FIB [(14.58±3.89)s、(30.28±5.87)s、(5.10±1.66)g/L] 均高于对照组[(13.09±1.06)s、(27.88±2.74)s、(3.93±1.01)g/L](P均<0.05),但治疗前后之间无差异(P均>0.05)。 3. 氧化应激指标:3.1 AECOPD患者治疗前血浆TAC(3.35±0.54)U/ml比治疗后(3.76±0.31)U/ml明显降低(P<0.01),经治疗后虽有所升高,但仍显著低于健康对照组(4.15±0.26)U/ml(P均<0.01)。3.2 AECOPD患者治疗前血浆MDA(12.18±2.50)nmol/ml明显高于治疗...
Other AbstractObjective To observe the change of oxidative stress and the level of tissue factor (TF) activity, tissue factor pathway inhibitor (TFPI) activity, and their ratio (TF/TFPI) of plasma in the patients with chronic obstructive pulmonary disease during acute exacerbation (AECOPD) before and after treatment. To explore the relationship between coagulation/anticoagulation imbalance and oxidative stress in AECOPD patients before and after treatment. Methods TF activity and TFPI activity of plasma were detected by chromogenic assay in 28 AECOPD patients before and after treatment and in 30 healthy persons. The total antioxidative capacity (TAC) in plasma was measured by o-phenanthroline colorimetric analysis. The content of malondialdehyde (MDA) in plasma was measured by thiobarbituricacid colorimetric analysis. The glutathione peroxidase (GSH-PX) in plasma was detected by 5, 5'- dithiobis- 2- nitrobenzoic acid (DNTB) method. The prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) in plasma were detected by Nephelometry. The respiratory function were measured by lung function, arterial blood gas testing and modified medical research council dyspnea scal (MMRC) respectively in AECOPD patients before and after treatment. Results 1. The indexes associated with respiratory function: 1.1 The lung function in AECOPD patients before treatment [FEV1% (40.64±17.14)%, FEV1/FVC% (47.09±11.55)%] was significantly lower than that after treatment [FEV1% (52.16±24.07)%, FEV1/FVC% (53.93±13.66)%] (P all < 0.05) respectively, but they were all still lower than that in healthy persons[FEV1% (104.10±14.73)%、FEV1/FVC% (81.03±7.00)%] (P all < 0.01). 1.2 The level of PaO2 and SaO2% in AECOPD patients before treatment [(47.32±8.81) mmHg, (81.54±10.83)%] was significantly lower than that after treatment [(55.48±7.11)mmHg, (88.61±4.10)%] (P all < 0.01) respectively, but there was no statistical difference of PaCO2 in AECOPD patients before (41.89±8.76) mmHg and after (41.17±8.73) mmHg treatment (P > 0.05). 1.3 The percentage of neutrophils in AECOPD patients before treatment (69.05±10.80)% was significantly higher than that after treatment (61.67±8.33)% and that in healthy persons (58.12±7.26)% (P < 0.01 or < 0.05) respectively, but there was no statistical difference of the percentage of neutrophils in AECOPD patients after treatment and in healthy persons (P > 0.05). 1.4 The dyspnea scale in AECOPD patients before treatment (2.8...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222984
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
黄瑾. 慢性阻塞性肺疾病患者凝血功能异常与氧化应激关系研究[D]. 兰州. 兰州大学,2011.
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