老年COPD急性加重期合并2型糖尿病患者血浆D-二聚体的动态变化

摘要

Objective To investigate dynamic changes of plasma D-dimer, C-reactive protein (CRP) and fasting plas⁃ma glucose (FBG) levels in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with type 2 diabetes mellitus. Methods AECOPD group (n=65) was used as A group, AECOPD combined with type 2 diabetes mellitus group (n=65) was used as B group. Levels of D-dimer, CRP and FBG were observed and compared between two groups in the first day, the 3rd day, the 7th day and the 14th day after hospital admission. The correlation be⁃tween D-dimer, CRP and FBG was analyzed. Logistic regression analysis was used to estimate the factors affecting increased plasma levels of D-dimer. Results Levels of D-dimer, CRP and FBG were significantly higher in B group than those of A group in the first day, the 3rd day, the 7th after hospital admission (P<0.01). Values of D-dimer and CRP were declined ob⁃viously in A group in the 7th day after hospital admission, but in B group they were declined obviously until the 14th day. There was no significant difference in FBG of A group. The level of FBG was significantly decreased in B group. There was a positive correlation between D-dimer, CRP and FBG (P<0.05). Logistic regression analysis showed that CRP, FBG, p(O2) and age were the influence factors for the increased levels of D-dimer. Conclusion In elderly patients with AECOPD com⁃bined with type 2 diabetes mellitus, we should pay attention to anti-inflammatory and controlling blood sugar, and the dy⁃namic monitoring levels of D-dimer, which helps to improve the prognosis for patients with AECOPD, and reduce mortality.%目的：探讨老年慢性阻塞性肺疾病急性加重期（AECOPD）合并2型糖尿病患者血浆D-二聚体、C-反应蛋白(CRP)、空腹血糖(FBG)水平的动态变化特点。方法选取单纯AECOPD组（A组）65例和AECOPD合并2型糖尿病组（B组）65例，观察并比较2组入院后第1、3、7、14天D-二聚体、CRP、FBG水平的变化，分析D-二聚体、CRP、FBG的相关关系，Logistic回归分析D-二聚体水平升高的因素。结果 B组D-二聚体、CRP、FBG在入院后第1、3、7天均高于A组（P<0.01）；D-二聚体、CRP值在A组自入院后第7天明显下降,在B组直到第14天明显下降；A组入院后各时间段FBG变化无明显差异，入院后B组FBG呈下降趋势；D-二聚体、CRP、FBG三者间均呈正相关（P<0.05）；CRP、FBG、p（O2）、年龄是影响D-二聚体水平升高的因素。结论老年AECOPD合并2型糖尿病的患者在抗感染和控制血糖的同时，应注意动态监测D-二聚体水平，有助于改善AECOPD患者的临床及预后，降低病死率。