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目的探讨主动脉Stanford B型主动脉夹层患者凝血功能的变化及其临床意义。方法 2002年1月至2011年1月新疆维吾尔自治区人民医院收治Stanford B型主动脉夹层99例,选性别与年龄匹配的正常对照组95例,全自动血凝分析仪检测入选人群入院时国际化标准比值(INR)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)和D-二聚体(DD)。结果夹层组INR、APTT、FIB、DD均高于对照组,TT低于对照组(P均<0.01)。主动脉夹层分期内比较,亚急性及慢性期组夹层INR、FIB高于急性期夹层组(P均<0.01),APTT、DD、TT未见明显改变。结论 Stanford B型主动脉夹层表现为凝血与纤溶持续激活,凝血与纤溶间的平衡被破坏而产生高凝状态。
Objective To investigate the changes of coagulation function in patients with aortic dissection of Stanford type B and its clinical significance. METHODS: From January 2002 to January 2011, 99 patients with Stanford type B aortic dissection were selected from People’s Hospital of Xinjiang Uygur Autonomous Region. Ninety-five normal controls and 95 age-matched matched controls were selected. The automatic hemagglutination analyzer (INR), partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT) and D-dimer (DD). Results The levels of INR, APTT, FIB and DD in the mesenteric group were significantly higher than those in the control group, but TT was lower than that in the control group (all P <0.01). In the aortic dissection, the levels of INR and FIB in the subacute and chronic phases were higher than those in the acute phase (all P <0.01), and no significant changes in APTT, DD and TT were observed in the aortic dissection. Conclusion Stanford B type aortic dissection showed continuous activation of coagulation and fibrinolysis, and the balance between coagulation and fibrinolysis was destroyed to produce hypercoagulable state.