Correlation Analysis Of D-dimer And FIB Of Patients In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease(AECOPD)with Acute Physiology And Chronic Health Evaluation ? Score(APACHE ? Score)

Objective : To explore the correlation between D-dimer and FIB of patients in Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)and Acute Physiology and Chronic Health Evaluation II Score(APACHEII Score),provide a new simple and effective method of assessment of the severity and prognosis of patients in acute exacerbation chronic obstructive pulmonary disease.Methods : 100 cases of hospitalized patients with chronic obstructive pulmonary disease as the research object in our hospital,According to the inclusion criteria of Acute Exacerbation of Chronic Obstructive Pulmonary Disease,we divided the cases into two group : the group in Acute Exacerbation of Chronic Obstructive Pulmonary Disease(acute phase group)and the group in stable phase of Chronic Obstructive Pulmonary Disease(stable phase group).At the same time,we select 30 adults with health examination as normal control group in the hospital physical examination center.We detect the plasma fibrinogen and D-dimer level of the above three groups in the morning fasting by collecting venous blood respectively,Comparison among the three groups of differences in the levels of plasma D-dimer and fibrinogen.APACHE II scores for the patients in the acute phase group.According to the results of APACHE II scores,we divided the patients in the acute phase group into three subgroup :APACHE II score?10,10 < APACHE II score < 20,APACHE II score?20,Comparison among the three subgroups of differences in the levels of plasma D-dimer and fibrinogen.At the same time,we analysis the correlations between the levels of plasma D-dimer and fibrinogen and APACHE II score in the acute phase group.followed up for six months for the patients in the acute phase group.According to the results of the prognosis,we divided the patients in the acute phase group into two subgroup: Death group and survival group.Comparison between the two subgroup of differences in the levels of plasma D-dimer and fibrinogen and APACHE II score respectively.Results: The age,sex differences in 100 patients with chronic obstructive pulmonary disease has no statistical significance(P > 0.05).The levels of plasma D-dimer and fibrinogen in the stable phase group higher than the normal control group,The levels of plasma D-dimer and fibrinogen in the acute phase group higher than the stable phase group,The difference were statistically significant(P < 0.01).The levels of plasma D-dimer and fibrinogen in the subgroup which APACHE II score?20 in the patients of the acute phase group higher than the subgroup which 10 < APACHE II score < 20,The difference were statistically significant(P < 0.01).The levels of plasma D-dimer in the subgroup which 10 < APACHE II score < 20 in the patients of the acute phase group higher than the subgroup which APACHE II score?10,The difference was not statistically significant(P > 0.05).The levels of plasma fibrinogen in the subgroup which 10 < APACHE II score < 20 in the patients of the acute phase group higher than the subgroup which APACHE II score?10,The difference was statistically significant(P< 0.01).The levels of plasma D-dimer and fibrinogen and the APACHE II score in the patients of the acute phase group was significantly and positively correlated by Spearman rank correlation analysis(r ==0.88,r=0.784,P <0.01).Followed up 6 months,9 cases were died in the patients of the acute phase group,mean age(73.44 + 14.65)years old,while 43 patients were still alive,average age(72.14±9.7)years old,The age differences has no statistical significance(P > 0.05).The levels of plasma D-dimer and fibrinogen and APACHE II score in Death group higher than survival group,The difference was statistically significant(P< 0.01).Conclusion:(1)The levels of plasma D-dimer and fibrinogen will be raised of the patients in Acute Exacerbation of Chronic Obstructive Pulmonary Disease;(2)APACHE II score can be used as a method to evaluate the severity and prognosis of patients in Acute Exacerbation of Chronic Obstructive Pulmonary Disease;(3)The levels of plasma D-dimer and fibrinogen and the APACHE II score was significantly and positively correlated;(4)combine APACHE II score of patients in Acute Exacerbation of Chronic Obstructive Pulmonary Disease and the levels of plasma fibrinogen and D-dimer was detected within 24 hours after admission,we can better evaluate the severity and prognosis of patients in Acute Exacerbation of Chronic Obstructive Pulmonary Disease,and to better guide the clinical treatment and care.