血浆D-二聚体和纤维蛋白原检测在慢性阻塞性肺疾病急性加重期合并低氧血症中的临床意义  

Clinical significance of plasma D-dimer and fibrinogen detection in patients with AECOPD with hypoxemia

作　　者：李梦蕾 伍阳 韩华静 袁永强[1] Li Menglei;Wu Yang;Han Huajing;Yuan Yongqiang(Department of Clinical Laboratory Medicine,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院检验科,402160

出　　处：《中国医师杂志》2020年第10期1464-1467,共4页Journal of Chinese Physician

基　　金：国家高技术研究发展计划(863计划)(2011AA02A111)。

摘　　要：目的探讨血浆D-二聚体(D-D)、纤维蛋白原(Fib)在慢性阻塞性肺疾病急性加重期(AECOPD)合并低氧血症时的变化及临床意义。方法选取2017年9月至2018年10月本院收治的AECOPD患者150例,根据其动脉血气分析结果分为单纯AECOPD组75例和AECOPD合并低氧血症组75例,另外选取同期健康体检者75例作为对照。各受试者分别抽取静脉血检测D-D、Fib及C-反应蛋白(CRP)等相关指标,并统计分析各组间这些指标的差异及相关性。结果 AECOPD合并低氧血症组的D-D及Fib明显高于单纯AECOPD组及健康对照组,且AECOPD组高于健康对照组,差异均有统计学意义(P<0.001)。在AECOPD组中,血浆Fib、D-D与CRP呈正相关(r=0.617,P<0.001;r=0.300,P=0.009),与PLT、WBC无相关性(P>0.05);在AECOPD合并低氧血症组中,血浆Fib与CRP、WBC及PLT均呈正相关(r=0.854,P<0.001;r=0.345,P=0.002;r=0.272,P=0.018),血浆D-D与CRP、WBC及PLT无相关性(P>0.05)。结论血浆D-D与Fib水平随着慢性阻塞性肺疾病(COPD)患者病情的加重而升高,可作为COPD进程中炎症评价的潜在标志物。Objective To explore the changes and their clinical significance of plasma d-dimer(D-D)and fibrinogen(Fib)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with hypoxemia.Methods 150 patients with AECOPD admitted to our hospital from September 2017 to October 2018 were selected and divided into simple AECOPD group(75 cases)and AECOPD combined with hypoxemia group(75 cases)according to the arterial blood gas analysis results.In addition,75 healthy people in the same period were selected as the control group.The D-D,Fib and C-reactive protein(CRP)level were detected in venous blood,and the differences and correlation of these indexes among the groups were statistically analyzed.Results The D-D and Fib of AECOPD combined with hypoxemia group were significantly higher than those of AECOPD group and healthy control group,and the AECOPD group was higher than the healthy control group(P<0.001).In AECOPD group,the plasma Fib and D-D were positively correlated with CRP(r=0.617,P<0.001;r=0.300,P=0.009),but not with platelets(PLT)and white blood cell(WBC)(P>0.05);in AECOPD combined with hypoxemia group,the plasma Fib was positively correlated with CRP,WBC and PLT(r=0.854,P<0.001;r=0.345,P=0.002;r=0.272,P=0.018),but there was no correlation between D-D and CRP,WBC and PLT(P〉0.05).Conclusions The plasma level of D-D and Fib increase with the aggravation of chronic obstructive pulmonary disease(COPD).They could be considered as potential inflammatory markers for the assessment of inflammation in the progression of COPD.

关 键 词：肺疾病 慢性阻塞性 低氧血症 D-二聚体 纤维蛋白原 

分 类 号：R563.9[医药卫生—呼吸系统]