Analysis Of Indexes Such As Hcy And D-Dimer In Patients With AECOPD Before And After Treatment

Objective:It is to explore the change of homocysteine?Hcy?,D-dimer?D-D?,prealbumin?PA?,cystatin C?Cys-C?,C-reactive protein?CRP?,arterial partial pressure of oxygen?PaO₂?,arterial partial pressure of carbon oxygen?PaCO₂?,carboxyhemoglobin?COHb?,chronic obstructive pulmonary disease assessment test?CAT?in patients before and after treatment for acute exacerbation of chronic obstructive pulmonary disease?AECOPD?,and to analyze the relativity between the above indicators and pulmonary function,to provide theoretical basis for the clinical diagnosis and treatment of AECOPD.Methods:Sixty patients with AECOPD who were hospitalized in the department of respiratory medicine of Affiliated Hospital of Hebei University of Engineering from September 2018 to October 2019 were selected as the experimental group,and 60healthy patients who underwent physical examination were selected as the control group.All patients were given routine treatment.Blood samples was collected on the day of admission and on the 10th day after treatment to examine COHb,PaO₂,PaCO₂,Hcy,D-D,PA,CRP and Cys-C.CAT score was also performed,and Pulmonary function was examined the 10th day after treatment.Blood was extracted from the control group to detect the above indicators,and lung function examination was conducted.The changes of the above indexes were observed before and after treatment in patients with AECOPD,The correlation between indexes and precentage of predicted value of forced expiratory volume in the first second after treatment was analyzed.Results:1.Before treatment,the levels of Hcy,D-D,CRP,Cys-C,COHb and PaCO₂ in the experimental group were higher than those in the control group?P<0.05?,while PA and PaO₂ levels were lower than those in the control group?P<0.05?.CAT score was higher than control group?P<0.05?.2.After treatment,the levels of Hcy,D-D,CRP,COHb and PaCO₂ in the experimental group were significantly lower than those before treatment?P<0.05?,while PA and PaO₂ levels were significantly higher?P<0.05?.CAT was significantly lower than that before treatment?P<0.05?.After treatment,Cys-C decreased compared with that before treatment,but there was no statistical significance?P>0.05?.3.After treatment,the levels of Hcy,D-D,CRP,Cys-C,COHb and PaCO₂ in the blood of the experimental group decreased compared with that before treatment,but were still higher than that of the control group?P<0.05?,and PA and PaO₂ levels were significantly lower than those of the control group?P<0.05?.FEV1%pred and FEV1/FVC in the experimental group were significantly lower than those in the control group?P<0.05?.4.After treatment,COHb,PaCO₂ and CAT scores of the experimental group were negatively correlated with FEV1%pred?P<0.05?.PaO₂ was positively correlated with FEV1%pred?P<0.05?.Blood Hcy,Cys-C,D-D,CRP,PA were not correlated with FEV1%pred?P>0.05?.Conclusions:The combination and dynamic monitoring of changes in Hcy,D-D,Cys-C,CRP,PA,PaO₂,PaCO₂,COHb and CAT can have a certain push action for the clinical diagnosis and treatment of AECOPD;The above indexes have been improved after treatment,but still can not reach the level of healthy people,suggesting that the treatment of COPD is a long-term process;The detection of PaO₂,PaCO₂,COHb and CAT is helpful to judge the pulmonary function of COPD patients.