Analysis The Clinical Significance Of Troponin ?and D-dimer In AECOPD Patients

Objective: To investigate the expression of D-dimer and troponin I in serum of stable COPD patients and AECOPD patients,and to analyze the relationship between D-dimer and troponin I expression and clinical characteristics and treatment outcome of AECOPD patients.Secondly,ROC curves were used to analyze the diagnostic value of D-dimer and troponin I in AECOPD,providing a theoretical basis for the diagnosis and prognosis evaluation of AECOPD.Methods: From June 2016 to June 2017,100 patients with stable COPD and 100 patients with acute exacerbation of COPD were collected in the respiratory department of a certain hospital.The patient's age,sex,treatment methods,treatment outcomes and acute exacerbation frenquency in the coming year were obtained by means of case information and return calling.Within 24 hours after admission,fasting venous blood was collected and centrifuged at 1000 rpm for 10 minutes.The level of D-dimer in serum was detected by automatic coagulation analyzer.Serum troponin I level was detected by Dimension LOCI.Results: Thesex ratio and average age of stable COPD and AECOPD patients had no significant difference(P>0.05).The levels of troponin I and D-dimer in serum of patients with AECOPD were significantly higher than those of stable COPD patients(P?0.05).The area under the curve of combined diagnosis of troponin I,D-dimer,troponin I and D-dimer was 0.665,0.825 and 0.822 respectively,statistically significant.There was no significant difference of troponin I and D-dimer levelsin serum of AECOPD patients between different lung function grades(P>0.05).The serum levels of troponin I and D-dimer in patients with respiratory failure were significantly higher than those in patients without respiratory failure(P?0.05).On the analysis of prediction value of respiratory failure,the cut off value of troponin I is 0.008ng/ml,while D-dimeris 0.55ng/L,statistically significant.The levels of troponin I and D-dimer increased in turn with the severity of AECOPD and the increase ofacuteexacerbation frenquency in the coming year.On the analysis of prediction value of acute exacerbation frequency,prediction value of troponin I is low,while the cut off value of D-dime is 0.515mg/l when the acute exacerbation frequency is 1 time or more than,and the cut off value of D-dime is 0.805mg/l when the acute exacerbation frequency is 2 times or more than,statistically significant.The levels of serum troponin I and D-dimerwere significantly higher in patients with death than in patients with survival(P?0.05).Conclusion:1.The levels of troponin I and D-dimer in serum of patients with AECOPD were significantly higher than those of stable COPD patients.2.D-dimer had a predicted value in acute exacerbation of COPD,while troponin I had a low predicted value in acute exacerbation of COPD.3.The expressions of troponin I and D-dimer were significantly elevated in AECOPD patients with respiratory failure,death,high acute exacerbation frequency in the coming year and high severity of disease.4.Whentroponin I is more than 0.008ng/ml or D-dimer is more than 0.55mg/L,it has a predicted value for respiratory failure in AECOPD patients.D-dimer is more than 0.515mg/ml and D-dimer is more than 0.805mg/L has a predicted value for ?1 and 2 acuteexacerbation respectively in the coming year in AECOPD patients.