纤维蛋白原、D二聚体与慢性阻塞性肺疾病继发呼吸衰竭的预后关系  

Value of D-Dimer and Fibrinogen in COPD with Respiratory Failure

作　　者：胡国平[1] 喻延[1] 梁伟强[1] 李芳[1] 吴泽龙[1] 

机构地区：[1]广州医学院第三附属医院呼吸内科,广州510150

出　　处：《血栓与止血学》2012年第4期176-178,187,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨纤维蛋白原、D二聚体在慢性阻塞性肺疾病(COPD)合并呼吸衰竭中的临床价值。方法对我院呼吸内科收治的137例COPD患者的资料进行分析,根据血气分析结果及患者的最终预后,将患者分为无呼吸衰竭组、呼吸衰竭好转组及呼吸衰竭死亡组,比较三组纤维蛋白原、D二聚体水平;同时根据D二聚体水平,将患者分为D二聚体小于500 ng/ml组、500～1000 ng/ml组以及大于1000 ng/ml组,比较其预后及其血气分析的差异。结果无呼吸衰竭组、呼吸衰好转组及呼吸衰竭死亡组血浆D二聚体分别为283.0±311.1 ng/ml、315.9±442.5 ng/ml、997.9±1501.8 ng/ml,差异有统计学意义;而纤维蛋白原两组相比差异无统计学意义。D二聚体小于500 ng/ml组、500～1000 ng/ml组,以及大于1 000 ng/ml组的死亡率分别为24.8%、57.14%,及73.68%,差异有统计学意义。D二聚体水平与动脉血pH值密切相关,而与血氧分压和二氧化碳分压无关。结论 D二聚体增高是COPD继发呼吸衰竭患者死亡的一个危险因素。Objective To investigate the clinical significance of D-dimer （D-D ） and fibrinogen （Fbg） in chronic obstructive pulmonary disease （COPD） patients with respiratory failure. Methods According to blood gas analysis and prognosis, the 137 COPD patients were divided into three groups： COPD without respiratory failure group （WRF group）, respiratory failure improvement group （RFI group）, and respiratory failure death group （ RFD group）. The plasma D- D and Fbg were measured. According to the level of D-D, patient were divided into three group： D-D less than 500 ng/ml group ,501 - 1000 ng/ml group and more than 1 000 ng/ml group. The mortality, pH ,PaCO2 and PaO2 of the three group were compared. Results The plasma D-D in WRF group, RFI group and RFD group were 283.0 ±311.1 ng/ml,315.9 ±442.5 ng/ml and 997.9 ± 1501.8 m; （P 〈 0.05）. The Fbg in the three group were 3.71 ± 1.34 g/L, 3.85 ± 1.07 g/L and 3.30 ± 1.18 g/L （P 〉0.05）. The mortality in D-D less than 500 ng/ml group ,501 ± 1000 ng/ml group and more than 1 000 ng/ml group were 24.8% ,57.14% and 73.68% （P 〈 0.05）. The plasma D- D is related with pH. Conclusion D-D is a death factor for COPD accompanied with respiratory failure.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 D二聚体 

分 类 号：R563[医药卫生—呼吸系统]