Abstract:

Activated partial thromboplastin time (APTT) is a common screening test for coagulation. Multiple causes, such as coagulation factor deficiency, presence of coagulation factor inhibitors, or lupus anticoagulants, can lead to prolonged APTT, but the treatment options and outcomes are quite different. This article reports the diagnosis and treatment of a patient with chronic obstructive pulmonary disease and persistent prolonged APTT. The patient had a previous diagnosis of chronic bronchitis and was admitted to Nanyang Central Hospital on December 6, 2021 because of fever and shortness of breath exacerbated after activity. He was initially found to have a significantly prolonged APTT (up to the critical value criteria), which was not corrected by plasma infusion and vitamin K. The APTT mixing test indicated antiphospholipid syndrome. The patient's conditions were improved significantly after hormonal treatment. This report is intended to deepen clinicians' understanding of the APTT mixing test, to improve the application of this test in primary testing laboratories, and to help clinicians quickly identify patients at risk for bleeding or thrombosis and reduce missed diagnoses and misdiagnoses.

Key words:

Chronic obstructive pulmonary disease, Activated partial thromboplastin time, Systemic lupus erythematosus, Antiphospholipid syndrome

摘要：

活化部分凝血活酶时间（APTT）是常见的出凝血功能筛选试验，多种原因（如凝血因子缺乏、存在凝血因子抑制物或狼疮抗凝物）均可导致APTT延长，但其治疗方案和结局却完全不同。本文报道1例持续APTT延长的慢性阻塞性肺疾病患者诊疗经过，患者既往诊断慢性支气管炎，因发热伴气喘，活动后加重于2021年12月6日就诊于南阳市中心医院。初诊发现APTT显著延长（达危急值标准），血浆输注和维生素K制剂均无法纠正APTT延长，后选择APTT纠正试验提示疑似抗磷脂综合征，遂糖皮质激素治疗后患者状况明显好转。通过此报道，以期加深临床医师对APTT纠正试验的认识，同时提高该试验在基层检验实验室的应用，为临床医师快速识别患者出血或血栓风险、减少漏诊和误诊提供帮助。

关键词:

慢性阻塞性肺疾病, 活化部分凝血活酶时间, 系统性红斑狼疮, 抗磷脂综合征