Prethrombolic state and efficacy of anticoagulation of patients with acute exacerbations of chronic obstructive pulmonary disease

Abstract

Objective To investigate prethrombolie state and observe the effect of anticoagulation therapy in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods The patients with AECOPD were randomly divided into anticoagulation group and control group.In anticoagulation group low molecular weight heparin (6 000 IU,Qd) was added besides the conventional therapy for 7-10 days,and in control group patients only accepted the conventional therapy.The indexes of hemorheology,vWF,GMP-140,t-PA,Pal-1 and blood gas indexes were detected before and after therapy,Results Blood viscosity,plasma viscosity,erythrocyte deformability index significantly decreased and erythrocyte aggregability index significantly increased in anticoagulation group after therapy compared with those before therapy( P＜0.01,respectively),whose degrees of improvement in anticoagulation group were significantly higher than those of control group ( P＜0.05,respectively).GMP-140,vWF,PAI significantly decreased and t-PA increased in anticoagulation group alter therapy compared with those before therapy( P＜0.01,respectively),whose degrees of improvement in anticoagulation group were significantly higher than those of control group( P＜0.05,respectively).Compared with control group,PaO2 was significantly increased in anticoagulation group( P＜0.05).The changes of GMP- 140,vWF,PAI were negatively correlated with the improvement of PaO2(r=-0.570,-0.909,-0.915,P＜0.05)and the change of t-PA was positively correlated with the improvement of PaO2 (r=0.625,P＜0.05).There was statistical significance in the curative effect between two groups ( P＜0.05).Conclusions Prethrombolic state exists in patients with AECOPD in hospital.Anticoagulation therapy can contribute to correct coagulation-fibrinolysis abnormalities and hypercoagulabale state to improve the curative effect. Key words: Chronic obstructive pulmonary disease; Prethrombolic state; Low molecular weight heparin