AECOPD患者血浆D-二聚体水平与肺功能的关系

摘要

目的：：探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血浆 D-二聚体(DD)水平与肺功能的关系。方法：收集2010年9月至2013 年9月在我科住院的所有 AECOPD患者,患者入院次日检测血浆 DD水平和肺功能,将 DD阳性者随机分为DD阳性治疗组(n=18)和DD阳性对照组(n=22)及DD阴性对照组(n=36),每周复查血浆DD水平和肺功能。结果：AE-COPD患者DD阳性率为33%(82/248)；与DD阳性对照组相比,在治疗后第7天,DD阳性治疗组患者血浆DD水平显著下降(P<0.05),FEV1%预计值、FEV1/FVC等肺功能显著改善(P<0.05)；患者 FEV1%预计值、FEV1/FVC、DLCO/VA与血浆 D-二聚体变化呈负相关(分别为r=-0.661,P<0.05；r=-0.717,P<0.05；r=-0.665,P<0.05)。结论：部分AE-COPD患者存在血液高凝状态；低分子肝素能有效降低 AECOPD患者血浆 DD水平,抑制肺血管微血栓形成,促进 AECOPD患者肺功能快速好转。%Objective:To explore the relationship between the level of D-dimers in plasma and lungs function in patients with acute exacerbation of Chronic obstructive pulmonary disease(AECOPD)and its potential mechanism. Methods:The consecutive patients with AECOPD admitted in the geriatrics respiratory disea-ses division in the last three years were recruited into the present study. Subj ects with D-dimer level more than 450ng/ml were divided into low molecular weight heparin calcium(LMWHC)treatment group and control group randomly and D-dimer level in plasma and lungs function were detected one times a week. Results:Thirty-three percent of the patients with AECOPD plasma D-dimer level more than 450ng/ml. When compared with controls,the level of D-dimers in group treatment was decreased significant,and lungs function was improved significant (P <0.05 ). There were negative correlation between FEV1%pred,FEV1/FVC,DLCO/VA and D-dimer concentration in plasma. Conclusion:The incidence of D-dimer positive (more than 450ng/ml)in patients with AECOPD was 33%. There were significant negative corre-lation between FEV1%pred,FEV1/FVC,DLCO/VA and levels of plasmas D-dimer,separately,in pa-tients with AECOPD.LMWHC might inhabit microthrombus and improve lungs function in patients with AECOPD.