The Relationship Between The Concentration Of D-Dimers In Plasma And Lungs Function In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

OBJECTIVE To explore the relationship between the concentration of D-dimers in plasma and lungs function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its potential mechanism.METHODS The concecutive patients with AECOPD adimitted in the geriatrics respiratory diseases division from September 2008 to September 2010 were recruited into the present study. D-dimers level in plasma and lungs function were detected in all subjects. Subjects with D-dimers level more than 450ng/ml were divided into low molecular weight heparin calcium treatment group and control group randomly base on the order of adimitted. Besides treated according to COPD guidelines as controls, subjects of treatment group were treated with low molecular weight heparin calcium abdominal subcutaneous injection 4100U/day, for five consecutive days. After two weeks, D-dimers and lungs function of between groups subjects were assessed.RESULT The total case with AECOPD in the present study was 124, and the case with D-dimers more than 450ng/ml was 41 (33.06 %). Randomly assigned to low molecular weight heparin calcium treatment group 20 and control group 21 patients. Some subjects were exited from the study because they could not tolerate repeated lungs function testing. Low molecular heparin treatment group was 9 cases, the average age is (80.9±7.9) years old. Control group was 11 cases, the average age is (80.4±4.2) years old. After two weeks treatment, the concentration of D-dimers in group treatment was decreased significant, and lungs function was improved significant when compared with controls (P<0.05). There were negative correlation between FEV1, FEV1/FVC, TLCO/VA% and D-dimers concentration in plasma.CONCLUSION The incidence of D-dimers positive (more than 450ng/ml) in patients with AECOPD was 33%. There were significanty negative correlation between FEV1, FEV1/FVC, TLCO/VA% and concentration of plasmas D-dimers in patients with AECOPD. LMWHC might inhabit microthrombus and improve lungs function in patients with AECOPD.