Clinical Observation Of Idiopathic Pulmonary Fibrosis With High Coagulation State

Objective:To observe the characteristics of idiopathic pulmonary fibrosis (IPF) inpathogenesis of hypercoagulable state, and investigate the relationship betweencoagulation index, arterial blood gas analysis and pulmonary function, toexplore the application value of clinical laboratory indicators to evaluatethe patients condition and the treatment effect, to broaden the idea of cliniciansin the diagnosis and treatment of IPF.Methods:In this study，48cases of IPF patients were collected from Department ofRespiratory Medicine in the Norman Bethune first Hospital of Jilin Universityfrom December2012to February2015, as IPF group, mean age (65.02±7.33),male38cases, female10cases, on the basis of the "2011diagnostic criteria foridiopathic pulmonary fibrosis evidence-based guidelines for Diagnosis andmanagement". In our hospital40cases of healthy people were chosen as controlgroup, whose arterial blood gas analysis, pulmonary function andHRCT examination have no abnormalities and with out ofheart, brain, liver health, kidney and other system disease, mean age(63.68±5.70), male30cases, female10cases. Determine the Coagulation index of the IPF group and the control group, analysis the differences between eachindex to see whether there were statistics differences among the two groups.Through correlation analysis to see whether the coagulation indexes of patientsin group IPF were correlated with PaO2and DLCO. My study divide the patientsin IPF group into two groups: steroid hormone treatment group andnon steroid hormone treatment group, treatment were followed up for4weeks, observe the changes of lung function, PaO2, blood coagulationindex and dyspnea inpatients after treatment, to see whether the changes havestatistically significant.Results:1. Compared with the control group, IPF group had higher level of FBG, thedifference had statistical significance (P<0.05), D-dimer level had significantstatistical significance difference (P <0.01).2. In the IPF group, FBG level was negatively correlated with DLCO (r=-0.501, P<0.01). The regression equation was y (DLCO)=-2.815x (FBG)+50.789. FBG level was negatively correlated with PaO2(r=-0.468,P＜0.01). The regression equation was y (PaO2)=-2.159x (FBG)+64.309.3.FBG and D-two dimer were increased after treatment in the steroid hormonetreatment group, the difference had statistical significance (P<0.05).4. In the steroid hormone treatment group and non steroid hormone treatmentgroup, PaO2were both increased after treatment, the difference had statisticalsignificance (P<0.05). Compared with the non steroid hormone treatment group, PaO2has more effective improved in the steroid hormonetreatment group (P<0.05).Conclusions:1. IPF patients have high blood coagulation state, glucocorticoid treatmentwith IPF patients can increase the hypercoagulable state.2. The fibrinogen content can suggest pulmonary diffusion function state andPaO2, can further reflect the conditions of patients, have great importance toassess the condition of patients.3. In the early disease of IPF glucocorticoid treatment (glucocorticoid+N-acetylcysteine+macrolide antibiotics) than non-glucocorticoid treatment (N-acetylcysteine+macrolide antibiotics) can effectively relieve patientswith dyspnea and hypoxemia.4. Intervening the abnormal coagulation system and fibrinolytic system maybecome a new and effective method for treatment of IPF.