The Changes And Clinical Value Of Plasma D-dimer In Senile Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective To study plasma D-dimer level changes of the senile patients with acute exacerbation of chronic obstructive pulmonary disease, and to explore the mechanisms and clinical valure.Methods Eighty-eight hospitalized patients were selectively collected in Ningxia General Hospital affiliated to Ningxia Medical University from January 2012 to December 2014, with acute exacerbation of COPD, and the age of them ranged from 60 to 80 years old. They were divided into several groups separately according to COPD severity classification, chest CT imaging manifestation and arterial blood gas analysis results. The plasma D-dimer level of patients were surveyed and compared between different groups. Results were analyzed with statistics, to contrast that they have or not statistic difference between them.Results According to COPD severity classification, plasma D-dimer content of moderate and severe/extremely severity group were both higher than in mild group(1.41±1.04 vs 0.55±0.33,1.79±1.32 vs 0.55±0.33), the difference was statistically significant(all P<0.05). In accordance with chest CT imaging manifestation, D group with infection, emphysema and lung interstitial change had got a highest D-dimer level(2.92 ± 1.64). Comparisons between any two groups were significantly different(all P<0.05) but not no abnormal groups(A group) and single imaging manifestation(B group). As grouping through arterial blood gas results, D-dimer content were increased in both type I and type II respiratory failure groups compared with normal ones(1.59±1.42 vs 0.88±0.56,2.26±1.29vs 0.88 ± 0.56), and the difference was statistically significant(all P < 0.05). Correlation analysis revealed a negative correlation between plasma D-dimer and PaO2(r=-0.464, P<0.05), whereas no correlation with PaCO2(r=0.157, P>0.05).Conclusions Senile patients with acute exacerbation of COPD appeared increased content of plasma D-dimer, which was closely related to COPD severity classification, complexity of chest CT imaging manifestation and arterial blood gas index, and D-dimer content is a significative observed index of evaluating hypercoagulability in clinical diagnosis.