The Clinical Significance Of Plasma D-dimer,Fibrinogen In Patients Of AECOPD And Intervention Characteristics And Effect Evaluation Of XueBiJing

Objective:Discussion the clinical significance of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients With Plasma D-dimer,Fibrinogen,Observed the effect on plasma D-dimer,Fibrinogen of XUBIJING Injection,Evaluated the effect on XUBIJING Injection in the treatment of AECOPD patients.Methods:According to inclusion criterions,57 AECOPD patients from Novemenber 2007 to January 2009 in our hospital were divided randomly into tow groups,30 cases as treated group,which were treated with XUBIJING Injection and conventional therapy of western medicine.27 cases as controlled group,which were treated with conventional therapy of western medicine only.Then,according to Traditional Chinese Medicine(TCM) dialectic criterions;57 cases were divided into cold.syndrome type(including cold spit TCM type and cold breahe TCM type) and heat syndrome type(including heat spit TCM type and heat breahe TCM type).There were 13 cases of cold syndrome type and 17 cases of heat syndrome type in treated group,12 cases of cold syndrome type and 15 cases of heat syndrome type in controllde group.All patients were given conventional therapy of western medicinesuch as controllable oxygen treatment,anti-infection,spasmolysis,dissipating phlegm and antasthmatic,and treated group was added XUBIJING Injection.period of treatment 10 days.The syndrome and objective sign were observed,as well as the pulmonary function,the levels in plasmas FB ang D-D were detected before treating and the first day after treating.At last,all data were analyzed by SPSS 13.0 for windows.Results:1.The Fibrinogen(FB) level before treatment was significantly higher than after treatment(P＜0.01);The FEV1 level before treatment was lower than after treatment(P＜0. 01);The FB level was negatively correlated with FEV1 after treatment(r=- 0.706,P＜0. 01);The FB level was negatively correlated with FEV1 before treatment(r=- 0.840,P ＜0.01);The FB level was negatively correlated with PaO2 before treatment(r=- 0.740, P＜0.01);The FB level was positively correlated with PaCO2 before treatment(r=0.621, P＜0.01).2.The D-dimer level in acute stage was superior than on stable stage;but statistical testing was no significant difference.3.The treated group was superior to the controlled group in the curative effect and the relieving of TCM syndrome such as cough,expectoration,breathe(p＜0.05),but there were not significant differences between the tow groups in rales(p＞0.05).4.After treatment,the pulmonary function was improved significantly in both groups(p＜0.05),but there were no significant differences between the two groups(p＞0.05).5.After treatment,the FB level was significantly low(p＜0.05),decline in the extent of the treatment group was higher than the control group.6.There were no significant differences in the curative effect between the cold syndrome type and the heat syndrome type(p＞0.05).7.There was no serious adverse effects in both groups.Conclusions:1.The FB level was associated with the severity of AECOPD,it can the target of the evaluation of the severity with AECOPD patients.2.The therapeutic efficacy ofconventional therapy of western medicine cooperated with XUEBIJING Injection in treating AECOPD is superior to conventional therapy of western medicine.3.XUBIJING Injection had reduced the plasma fibrinogen of AECOPDE patients, Improvement in patients with AECOPD hypercoagulable state,they maybe part of the mechanisms of treating AECOPD.4.There were no significant differences of clinical efficacy and adverse effects between the cold syndrome type and the heat syndrome type.The patients can endure the XUEBIJING Injection.It indicates that the XUEBIJING Injection is applicable to the cold and the heat syndrome type of AECOPD patients.