Study On The Relationship Between D-dimer,fibrinogen And Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

ObjectiveChronic Obstructive Pulmonary Disease(COPD)is a universal clinical chronic and respiratory-related disease that is a serious threat to human health.With the increase of air pollution and population aging,the mortality rate of COPD has been increasing year by year.The pathological feature of COPD is the persistent air flow limitation.D-dimer as a specific fibrinolytic process markers and fibrinogen(FIB)levels play an important role in the reflection of blood coagulation,at the same time to guide airway inflammation and lung tissue damage has some clinical significance.This article aims to investigate the clinical relevance of D-dimer and fibrinogen in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).MethodsThe study was conducted by reviewing past medical records and reviewing the clinical records of 80 patients with well-established chronic obstructive pulmonary disease who were hospitalized in our Respiratory Inpatient Ward from December 2015 to December 2016,Thirty cases of the stable COPD patients who were selected from our hospital respiratory medicine clinic by random sampling.The clinical data of 30 gender and age-matched medical staff were randomly collected from the physical examination center of our hospital during the same period.All admitted patients with acute exacerbation of chronic obstructive pulmonary disease in patients with fasting blood the next morning,for the physical examination center and stable COPD patients were collected on the day early morning fasting blood were taken by the Japanese Hommets Inc of CA5100 Automatic coagulation to analyzer for the detection of coagulation function APTT,PT,TT,DD,FIB.For patients with acute exacerbation of COPD before discharge or after the symptoms were stable,lung function tests were performed in our hospital.The levels of activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),D-dimer(DD)and Fibrinogen(FIB)differences in acute exacerbation of COPD group,stable COPD group and healthy control group.Acute progressive increase in patients with COPD as the dependent variable(yes = 1,no = 0),step-by-step forward-conditional regression method to select the cut-off p?0.05,the cut-off value p?0.10 as the standard according to the appellation standard,and APTT,PT,TT,DD,FIB,age,smoking index were selected as independent variables.Multivariate Logistic regression analysis was used to analyze the correlation between the above indexes and acute exacerbation of COPD patients.acute exacerbation of COPD Of patients were divided into grade ?,grade ?,and grade ?according to the GOLD level of pulmonary function test,and to compare the levels of DD and FIB in different levels of GOLD,statistically there was difference;To analysis the the correlation between DD,FIB in patients with acute exacerbation of COPD and FEV1 as a percentage of expected value.Results1.In the present study,the baseline age and gender were analyzed in COPD and healthy controls,including 77 males(70%)and 33 females(30%)in the COPD group,with an average age of(70.65 ± 7.95)years and there were 20 males(66.7%)and 10 females(33.3%)with a mean age of(69.67 ± 8.907)years in healthy controls.There was no significant difference in age and gender between the two groups(P> 0.05);2.The levels of APTT,PT,TT,D-D and FIB in patients with acute exacerbation of COPD,stable COPD patients and healthy controls were significantly different(P <0.05);3.The multivariate Logistic regression analysis of APTT,PT,TT,DD,FIB,age,smoking index and other indicators in COPD patients showed that elevated DD and FIB were independent risk factors for acute exacerbation of COPD patients(P < 0.05);4.Patients with acute exacerbation of COPD were classified according to the GOLD classification of lung function.There was significant difference in D-D and FIB levels between the three groups of grade?,and(P ? ? <0.05);5.There was a negative correlation between DD and FEV1%,the difference was statistically significant(r=-0.619,P= 0.000),FIB and FEV1% were negatively correlated with the predicted percentage(r =-0.706,P = 0.000).ConclusionDetection of D-D,FIB elevated serum levels suggest that in patients with COPD,especially acute exacerbations,there is clinical significance of prethrombosis hypercoagulable state.The unnatural D-dimer and fibrinogen were related with the order of severity of the disease.