Analysis Of Clinical Application Of Plasma Fibrinogen And D-dimmer In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective :This article detected and compared plasma fibrinogen and D-dimer levels between the patients with AECOPD and the healthy controls,and analyzed the relationships with the severity of airflow limitation and arterial blood gas analysis.It aimed to investigate the changes of blood coagulation status in AECOPD,and the clinical significance of plasma fibrinogen and D- dimer in evaluating the severity of the disease.Method:Chosen 72 cases of patients who were diagnosed with acute exacerbation of chronic obstructive pulmonary disease in the treatment of respiratory medicine in China-Japan Friendship Hospital of Jilin University during December 2014 to October 2015,the diagnosis on the basis of "Chronic obstructive Pulmonary Disease Guideline"(2013revision).Among which there are 39 males and 33 females, the youngest48 years old,and the maximum 85 years old.The average age is 64.90 ±10.94.According to the severity of airflow limitation in lung function is divided into 9 cases of mild group,24 cases of moderate group,26 cases of severe group and 13 cases of very severe group.All the patients should be required to rule out mental illness, complicating acute pulmonary embolism or other thromboembolic disease, severe liver and kidney disease, cancer, blood system diseases caused by coagulation abnormalities. Which also should be excluded those who with the history of trauma within the past three months, sugery,history of bleeding or received thrombolysis recently,or the application history of anticoagulation and antiplatelet aggregation drugs.Selected 70 cases from the hospital medical examination center during the same period as the healthy control group,including 36 males, 34 females, the youngest 45 years old, maximum 85 years old, with the average age 64.79 ± 11.19.Fasting plasma fibrinogen and D-dimmer were measured for all,while lung function and arterial blood gas analysis were checked for patients with AECOPD.Comparing the difference of plasma fibrinogen and Ddimer levels between the two groups,and analyzing the relationships between plasma fibrinogen and D- dimer levels in AECOPD with the severity of airflow limitation,analyzing the correlationship between plasma fibrinogen and D- dimer levels in AECOPD with Pa CO2 and Pa O2 as well.Results:1.Plasma fibrinogen and D-dimmer levels of the AECOPD group were higher than the healthy controls,the difference was statistically significant(P<0.05).2.Grouped by the severity of airflow limitation,plasma fibrinogen and D-dimmer levels of the mild group,moderate group,severe group,and very severe group AECOPD patients gradually increase,the difference was statistically significant between each group(P<0.05).3.In AECOPD patients, Pa CO2 level is positively corrected with plasma fibrinogen and D-dimmer(r=0.523,0.539,P<0.05),while Pa O2 level is negatively corrected with plasma fibrinogen and D-dimmer(r=-0.649,-0.550,P<0.05).Conclusion:1.The blood in patients with AECOPD has hypercoagulable state,and easily to the formation of pathological thrombus.2. Plasma fibrinogen and D-dimmer levels is gradually increased with the aggravation of airflow limitation in COPD,it has some clinical significance to evaluate the severity of the disease.3. Blood with hypercoagulable state in AECOPD is related to hypoxia and carbon dioxide retention.