Clinical Significance Analysis Of D-dimer And Fibrinogen To Evaluate The Illness Degree Of The Chronic Obstructive Pulmonary Disease

Objective:Chronic obstructive pulmonary disease is one common respiratory that features incompletely reversible airflow obstruction,the patients with more blood high condensation and other symptoms,the ascending tendency in recent years,therefore,prevention and treatment of COPD is urgently needed.To investigate the level of plasma of D–dimer and FIB of acute exacerbation of chronic obstructive pulmonary disease patients,and tested the pulmonary function and arterial blood gas analysis,provide a reference for clinical study in the disease assessment of COPD.Methods:110 cases stable COPD patients and 110 cases acute exacerbation COPD patients were collected in department of respiration of the third hospital affiliated to Suzhou university from May 2014 to March 2015 conducted the epidemiology investigation project of COPD in the area of Changzhou Yonghong and Wei country,stable COPD patients including 64 cases of male,female 46 cases,age 43-81 years old,the average age is（61.22±15.04）years old,acute exacerbation COPD patients including 61 cases of male,female 49 cases,age 42-80 years old,the average age is（61.58±12.39）years old.According to the guidelines of chronic obstructive pulmonary disease（2016 GOLD）espectively put cases of stable and acute exacerbation COPD patients into four groups:stable COPD patients:A₁group with stable COPD patients:48 cases patients,including 29cases of men and 19 cases of women,aged from 53 to 77 years old,the average age is（61.48±11.33）.B₁group with stable COPD patients:36 cases patients,20 cases of men and16 cases of women,aged from 55 to 77 years old,and the average age is（59.31±13.54）.C₁group with stable COPD patients:14 cases,including 8 cases of men and 6 cases of women,aged from 52 to 81 years old,and the average age is（63.53±12.88）.D₁group with stable COPD patients:12 cases,including 7 cases of men and 5 cases of women,aged from43 to 78 years old,and the average age is（63.18±13.02）.Acute exacerbation COPD patients:A₂group with acute exacerbation COPD patients:8 cases patients,including 4cases of men and 4 cases of women,aged from 52 to 78 years old,the average age is（61.23±11.22）.B₂group with acute exacerbation COPD patients:12 cases patients,7 cases of men and 5 cases of women,aged from 48 to 77 years old,and the average age is（61.57±12.55）.C₂group with acute exacerbation COPD patients:44 cases,including 30 cases of men and 14 cases of women,aged from 45 to 80 years old,and the average age is（62.89±12.67）.D₂group with acute exacerbation COPD patients:46 cases,including 20 cases of men and 24 cases of women,aged from 42 to 79 years old,and the average age is（62.17±12.80）.35 cases of normal healthy subjects of the same period examination as control group,including 27 cases of men and 8 cases of women,aged from 51 to 79 years old,and the average age is（64.14±11.08）.At the same time to exclude bronchial asthma,diabetes mellitus,hemopathy,hepatic renal dysfunction,gastrointestinal bleeding,acute cerebrovascular disease,left ventricular hypertrophy,malignant tumor,taking warfarin,aspirin of anticoagulant or antiplatelet drugs within two weeks and the patients don’t want to cooperate with treatment.The group were detected D-dimer and FIB in plasma;pulmonary function indicators were tested FEV₁,FVC,FEV₁/FVC and FEV₁pred%;Arterial blood gas analysis were detected PaO₂and Pa CO₂,and analysis the correlation between D-dimer,FIB and pulmonary function,arterial blood gas analysis.Results:1.Groups of patients with general clinical data on gender and age between groups have no statistical significance（P>0.05）;Compared with the control group,the FEV₁/FVC and FEV₁%pred in A₁group significantly decreased（P<0.05）;Compared with the A₁group,the FEV₁,FVC,FEV₁/FVC and FEV₁%pred in B₁group significantly decreased（P<0.05）;Compared with B₁group,the FEV₁,FVC,FEV₁/FVC and FEV₁%pred in C₁group and D₁group significantly decreased,difference was statistically significant（P<0.05）;Compared with the control group,the Pa CO₂in A₁group significantly improved,and the PaO₂significantly decreased（P<0.05）;Compared with the A₁group,the PaCO₂in B₁group significantly improved,and the PaO₂significantly decreased（P<0.05）;2.Compared with A₁group,the level of D-dimer and FIB in B₁group significantly improved（P<0.05）;Compared with B₁group,the level of D-dimer and FIB in C₁group and D₁group significantly improved,difference was statistically significant（P<0.05）;3.Compared with the every group of stable COPD patients,the D-dimer and FIB in every group of acute exacerbation COPD patients significantly improved（P<0.05）;Compared with the acute exacerbation group,the D-dimer and FIB of acute improvement group significantly decreased,difference was statistically significant（P<0.05）;4.D-dimer,FIB and lung function parameters such as FEV₁,FVC,FEV₁/FVC and FEV₁%pred have significant negative correlation（P<0.05）;5.There is a positive correlation between D-dimer and PaCO₂（r=0.421,P=0.000）,and there is a negative correlation between D-dimer and PaO₂（r=-0.887,P=0.000）;FIB and PaCO₂are positively correlated（r=0.511,P=0.002）,and there is a negative correlation between FIB and Pa O₂（r=-0.319,P=0.000）.ConclusionThe level of D-dimer and FIB with COPD patients higher than control groups,as the illness grew worse,the level of acute exacerbation COPD patients higher than stable COPD and acute improvement patients.There is a negative correlation between D-dimer,FIB and pulmonary function（FEV₁,FVC）and positive sorrelation with PaCO₂,negative sorrelation with PaO₂.