Evaluating Significance Of D-dimer And Hematocrit In Chronic Obstructive Pulmonary Disease

Objective: This article analyzes the change of d-dimmer andhematocrit in patients with AECOPD, and its correlationship with bloodgas analysis. The aim is to explore the change of blood coagulation stateand blood viscosity and significance of d-dimer and hematocrit inevaluating the progression and severity of the disease.Method: From Jan2014to Oct2014,94patients diagnosed withacute exacerbation of chronic obstructive pulmonary disease are chosen inthe respiratory department of The First Hospital of Jilin University,among which there are48male cases and46female cases. They have anaverage age of66.02±8.40. These patients are grouped by two ways:(1)Based on whether they have a complication of pulmonary arterialhypertension and the level of pulmonary artery systolic pressure, thesepatients are divided into a pure AECOPD group of57cases, a mildpulmonary hypertension group of25cases, and moderately severepulmonary hypertension group of12cases;(2) According to the results ofspirometry, patients are divided into a mild group of10cases, a moderategroup of30cases, a severe group of30cases, and a very severe group of 24cases. The diagnostic and grouping criteria was based on ChronicObstructive Pulmonary Disease Guideline (2013revision). Excluded arethose patients with diseases that might affect blood coagulation state, suchas hematonosis, cancer, severe liver and kidney disease, and acutecardiovascular and cerebrovascular embolism. Also excluded are thosepatients who have a history of bleeding, who received surgery orthrombolysis therapy recently, or used anticoagulation or antiplatelet drugs,and those patients with anemia, polycythaemia vera, severe vomiting,diarrhea, and large area burn.68volunteers with an average age of63.84±7.03, who are suggested by the physical examination in our hospital to behealthy, were chosen as the control group, among which there are37malecases and31female cases. D-dimer and HCT were measured for allselected patients, while blood gas analysis, spirometry and ultrasoniccardiogram were performed for patients with AECOPD. Comparing thed-dimer and HCT of patients in each group and its correlationship withblood gas analysis after grouped by above method.Result:1.D-dimer and HCT concentrations of the AECOPD group werehigher than healthy controls, the difference was statistically significant(P<0.01).2.D-dimer and HCT concentrations of the pure AECOPD group,mild pulmonary hypertension group and moderately severe pulmonary hypertension group gradually increase, the difference was statisticallysignificant between each group(P<0.05).3.Grouped by the results of spirometry, d-dimer and HCTconcentrations of the mild group, moderate group, severe group, and verysevere group AECOPD patients gradually increase, the difference wasstatistically significant(P<0.05).4.In AECOPD patients, PaO2level is negatively correlated withd-dimer and HCT (r=-0.487，-0.627, P<0.01), while PCO2level ispositively correlated with d-dimer and HCT (r=0.488，0.602, P<0.01).Conclusion:1.Patients with AECOPD have hypercoagulable state and increasedblood viscosity.2.The hypercoagulable state and increased blood viscosity areinvolved in the process of the form and aggravation of pulmonary arterialhypertension, d-dimer and HCT can be sensitive indexes in reflecting theprogress of disease.3.D-dimer and HCT level is associated with the changes ofspirometry, it can reflect the severity of airflow limitation.4.The formation of hypercoagulable state and increased bloodviscosity is associated with hypoxia and carbon dioxide retention, sothe d-dimer and HCT can be used as evaluation index of the severity ofillness.