D-二聚体检测判断慢性阻塞性肺疾病急性加重并肺栓塞患者预后的意义
|
摘要
目的:探讨慢性阻塞性肺疾病急性加重(AECOPD)合并肺栓塞(PE)患者的血浆D-二聚体水平与患者首次住院日、年发作次数和生存时间的关系。方法:收集AECOPD合并PE患者136例作为观察组,检测患者血浆D-二聚体水平,记录患者的首次住院日并随访3年,记录年发作次数和生存时间,分析血浆D-二聚体水平与首次住院日、年发作次数和生存时间的相关性,同时收集无合并PE的AECOPD患者265例作为对照组。结果:AECOPD合并PE组血浆D-二聚体水平、首次住院日和年发作次数明显高于对照组(P<0.01),3年生存率则明显降低(P<0.01)。AECOPD合并PE组血浆D-二聚体水平与首次住院日和年发作次数呈正相关(r=0.623、0.784,P<0.01),与生存时间呈负相关(r=-0.677,P<0.01)。结论:AECOPD合并PE患者血浆D-二聚体水平明显升高并与患者的首次住院日、年发作次数和生存时间密切相关,可以作为患者的短期和长期预后指标。
Objective:To investigate the relationship between plasma D-dimer levels and the first hospitalization days,annual attack times and survival time in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with pulmonary embolism(PE).Method:A total of 136 patients with AECOPD complicated with PE were collected as observation group and followed up 3 years.Plasma D-dimer levels were measured.The first hospitalization days and annual attack times and survival time were recorded.The correlation between the plasma D-dimer levels and hospitalization days,annual attack time and survival were analyzed.At the same time,265 AECOPD patients without PE were collected as control group.Result:The levels of plasma D-dimer,the first hospitalization days and annual attack times were significantly increase in observation group than those in the control group(P<0.01),while 3-year survival rate was significantly decrease(P<0.01).The plasma D-dimer level was positive correlation with the first hospitalization days and annual attack times respectively(r=0.623,P<0.01;r=0.784,P<0.01),while there was negative correlation with survival time(r=-0.677,P<0.01).Conclusion:The level of plasma D-dimer in patients with AECOPD complicated with PE was significantly increased and was closely related to the first hospitalization days,annual attack times and survival time.It could be used as a short-time and long-time prognostic index in patients.
Objective:To investigate the relationship between plasma D-dimer levels and the first hospitalization days,annual attack times and survival time in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with pulmonary embolism(PE).Method:A total of 136 patients with AECOPD complicated with PE were collected as observation group and followed up 3 years.Plasma D-dimer levels were measured.The first hospitalization days and annual attack times and survival time were recorded.The correlation between the plasma D-dimer levels and hospitalization days,annual attack time and survival were analyzed.At the same time,265 AECOPD patients without PE were collected as control group.Result:The levels of plasma D-dimer,the first hospitalization days and annual attack times were significantly increase in observation group than those in the control group(P<0.01),while 3-year survival rate was significantly decrease(P<0.01).The plasma D-dimer level was positive correlation with the first hospitalization days and annual attack times respectively(r=0.623,P<0.01;r=0.784,P<0.01),while there was negative correlation with survival time(r=-0.677,P<0.01).Conclusion:The level of plasma D-dimer in patients with AECOPD complicated with PE was significantly increased and was closely related to the first hospitalization days,annual attack times and survival time.It could be used as a short-time and long-time prognostic index in patients.
引文
[1]中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组.肺血栓栓塞症诊治与预防指南[J].中华医学杂志,2018,98(14):1060-1087.
[2]Akpinar E E,Ho?gün D,Akpinar S,et,al.Incidence of pulmonary embolism during COPD exacerbation[J].J Bras Pneumol,2014,40(1):38-45.
[3]Gao H,Liu H,Li Y.Value of D-dimer levels for the diagnosis of pulmonary embolism:An analysis of 32 cases with computed tomography pulmonary angiography[J].Exp Ther Med,2018,16(2):1554-1560.
[4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,6(4):67-80.
[5]中华医学会呼吸病学分会.肺血栓栓塞症的诊断与治疗指南(草案)[J].中华结核和呼吸杂志,2001,24(5):5-10.
[6]Cukic V,Baljic R.The Most Common Detected Risk and Etiologic Factors of Pulmonary Thromboembolism[J].Mater Sociomed,2012,24(4):223-226.
[7]Kim V,Goel N,Gangar J,et al.Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease[J].Chronic Obstr Pulm Dis,2014,1(2):239-249.
[8]Matsuo H,Nakajima Y,Ogawa T,et al.Evaluation of D-Dimer in Screening Deep Vein Thrombosis in Hospitalized Japanese Patients with Acute Medical Diseases/Episodes[J].Ann Vasc Dis,2016,9(3):193-200.
[9]Shapira-Rootman M,Beckerman M,Soimu U,et al.The prevalence of pulmonary embolism among patients suffering from acute exacerbations of chronic obstructive pulmonary disease[J].Emerg Radiol,2015,22(3):257-260.
[10]Choi K J,Cha S I,Shin K M,et al.Prevalence and predictors of pulmonary embolism in Korean patients with exacerbation of chronic obstructive pulmonary disease[J].Respiration,2013,85(3):203-209.
[11]陈淑娟,杨文兰,刘锦铭,等.肺栓塞患者肺功能特点的研究[J]国际呼吸杂志,2013,33(8):587-592.
[12]Fruchter O,Yigla M,Kramer M R.D-dimer as a prognostic biomarker for mortality in chronic obstructive pulmonary disease exacerbation[J].Am J Med Sci,2015,349(1):29-35.
[13]Hu G,Wu Y,Zhou Y,et al.Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD[J].Int J Chron Obstruct Pulmon Dis,2016,11:2729-2736.
[2]Akpinar E E,Ho?gün D,Akpinar S,et,al.Incidence of pulmonary embolism during COPD exacerbation[J].J Bras Pneumol,2014,40(1):38-45.
[3]Gao H,Liu H,Li Y.Value of D-dimer levels for the diagnosis of pulmonary embolism:An analysis of 32 cases with computed tomography pulmonary angiography[J].Exp Ther Med,2018,16(2):1554-1560.
[4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,6(4):67-80.
[5]中华医学会呼吸病学分会.肺血栓栓塞症的诊断与治疗指南(草案)[J].中华结核和呼吸杂志,2001,24(5):5-10.
[6]Cukic V,Baljic R.The Most Common Detected Risk and Etiologic Factors of Pulmonary Thromboembolism[J].Mater Sociomed,2012,24(4):223-226.
[7]Kim V,Goel N,Gangar J,et al.Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease[J].Chronic Obstr Pulm Dis,2014,1(2):239-249.
[8]Matsuo H,Nakajima Y,Ogawa T,et al.Evaluation of D-Dimer in Screening Deep Vein Thrombosis in Hospitalized Japanese Patients with Acute Medical Diseases/Episodes[J].Ann Vasc Dis,2016,9(3):193-200.
[9]Shapira-Rootman M,Beckerman M,Soimu U,et al.The prevalence of pulmonary embolism among patients suffering from acute exacerbations of chronic obstructive pulmonary disease[J].Emerg Radiol,2015,22(3):257-260.
[10]Choi K J,Cha S I,Shin K M,et al.Prevalence and predictors of pulmonary embolism in Korean patients with exacerbation of chronic obstructive pulmonary disease[J].Respiration,2013,85(3):203-209.
[11]陈淑娟,杨文兰,刘锦铭,等.肺栓塞患者肺功能特点的研究[J]国际呼吸杂志,2013,33(8):587-592.
[12]Fruchter O,Yigla M,Kramer M R.D-dimer as a prognostic biomarker for mortality in chronic obstructive pulmonary disease exacerbation[J].Am J Med Sci,2015,349(1):29-35.
[13]Hu G,Wu Y,Zhou Y,et al.Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD[J].Int J Chron Obstruct Pulmon Dis,2016,11:2729-2736.