The Correlative Study Of D-dimmer And Plasma Fibrinogen Level In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Diseases

Objective:To analyze the level of D-dimer,plasma fibrinogen and some thrombi function items,and the results of correlated arteries blood gas analysis in patients with AECOPD,on purpose to study the change of thrombi function and clinic significance in patients with AECOPD.Methods:53 patients with AECOPD treated in ICU in our hospital in January,2OO6—June,2007 were chosen:28 males,25 females, the age 59—85,the average age 70.2±5.5,corresponding to the treatment standard with COPD,simultaneously without patients with hepatic cirrhosis,hematonosis,cancer and patients who used anticoagulation,antiplatelet drugs within recent two weeks.45 examples were chosen in January 2006—June 2007 in our outpatient service health physical examination,23 males,22 females,the age 48—82,the average age 69±9.2.D-dimer,Fg, PT,APTT,TT,blood gas analysis(mainly PH,PaO₂,PCO₂) were measured in 53 patients with AECOPD and in 45 healthy controls to compare.Results: 1,D-dimer,Fg level were significantly higher in exacerbated patients:D-dimer concentration is(1.56±1.22)mg/L in AECOPD before treatment,obviously higher than(0.26±0.16) mg/L in healthy controls and(0.61±0.45)mg/L in patients in post-treatment group(P＜0.01).Fg concentration is(3.98±1.31)g/L in patients with AECOPD(pretherapy),significantly higher than(2.91±0.72)g/L in healthy controls and(3.01±0.73)g/L in patients in post-treatment group(P＜0.01).2,Elevated level of D-dimer and Fg is related to degradation level of PaO₂ and elevated level of PCO₂:in AECOPD group(pretherapy),arterial PO₂ offers significant negative correlation with hematoplasma D-dimer(r=-0.54,P＜0.01),PaCO₂ offers significant positive correlation with D-dimer(r=0.57, P＜0.01)。In AECOPD group(pretherapy),arterial PO₂ offers significant negative correlation with hematoplasma Fg(r=-0.68,P＜0.01),PaCO₂ offers significant positive correlation with Fg(r=0.74,P＜0.01)。3,D-dimer has the relevance with APTT and no relevance with PT,IT in patients with AECOPD:APPT is(46.21±8.97)s in patients with AECOPD before treatment,obviously different with(35.58±4.56)s in patients in post-treatment group and (34.84±3.18)s in healthy controls(P＜0.05).APPT is no significant difference between patients in post-treatment group and healthy controls.Patients with AECOPD before treatment D-dimer offers positive correlation with APTT (r=0.52,P＜0.05).Difference of PT,TT between patients in AECOPD and patients in post-treatment group and healthy controls is not obvious(P＞0.05).Conclusion:COPD under control has hypercoagulability state. It further intensifies in patients with AECOPD.The elevated D-dimer,Fg level in patients with AECOPD is related to the degradation of PaO₂ and the elevation of PCO₂.It can be regarded as one of the assessment index of the degree of AECOPD.