D-二聚体在高龄老年慢性阻塞性肺疾病急性加重患者中的临床意义  

Clinical significance of D-dimer in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：王建国 张东友 李昂[3] 马锦玲[3] 白永怿[3] Wang Jianguo;Zhang Dongyou;Li Ang;Ma Jinling;Bai Yongyi(Healthcare Room,Agency for Offices Administration of Central Military Commission,Beijing 100034,China;不详)

机构地区：[1]中央军委机关事务管理总局保健室,北京100034 [2]解放军第948医院心肾内科,乌苏833000 [3]中国人民解放军总医院第二临床中心心内科,北京100853

出　　处：《中国循证心血管医学杂志》2024年第10期1250-1252,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：解放军总医院医学工程实验室自主科研课题(2022SYSZZKY05);解放军总医院2017年第一批临床科研扶持基金(2017FC-WJFWZX-20)。

摘　　要：目的探讨高龄老年慢性阻塞性肺疾病急性加重(AECOPD)血浆D-二聚体水平的临床意义。方法回顾性分析2008年12月至2020年12月于解放军总医院第一、二临床中心诊断为ACOPD 2206例80~98岁的患者病历资料。随访30 d内需要机械通气的发生率及全因死亡率。比较两组血浆D-二聚体数值并进行统计学分析。结果2206例AECOPD患者,在30 d的随访过程中,179例患者需要行机械通气治疗,全因死亡率6.2%(137/2206)。未存活者组患者血浆D-二聚体含量均明显高于存活者(P<0.05);需要机械通气患者组血浆D-二聚体含量均明显高于不需要机械通气患者。多因素Logistic回归分析发现,D-二聚体不仅是预测30 d内是否存活的影响因素,也是预测是否30 d内需要机械通气的影响因素。采用Spearman相关性分析发现,D-二聚体水平与C反应蛋白(CRP)水平呈正相关性(P<0.05)。结论高龄老年AECOPD患者在30 d随访中,D-二聚体水平越高患者死亡及需要机械通气的风险越多,提示D-二聚体对于此类患者的预后具有一定参考和指导意义。Objective To discuss the clinical significance of plasma D-dimer(D-D)level in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical materials from ACOPD patients(n=2206,aged from 80 to 98)were retrospectively analyzed in the First and Second Clinical Centers of Chinese PLA General Hospital from Dec.2008 to Dec.2020.The patients were followed up for investigate the incidence of mechanical ventilation(MV)and all-cause mortality within 30 d.The difference of plasma D-D were compared and statistically analyzed among groups.Results During follow-up for 30 d,there were 179 patients with MV treatment,and all-cause mortality was 6.2%(137/2206).The level of plasma D-D was significantly higher in non-survival group than that in survival group(P<0.05),and was significantly higher in MV group than that in non-MV group.The results of multi-factor Logistic regression analysis showed that D-D was an influence factor for survival and MV requirement within 30 d.The results of Spearman correlation analysis showed that D-D level was positively correlated to level of C-reactive protein(P<0.05).Conclusion During follow-up for 30 d,the higher D-D level is,the higher the MV requirement risk is,which indicates that D-D has some reference and guidance significance for prognosis in elderly AECOPD patients.

关 键 词：慢性阻塞性肺疾病 老年 D-二聚体 

分 类 号：R563[医药卫生—呼吸系统]