| 来焱,杨瑞青.D-二聚体联合二氧化碳分压检测在慢性阻塞性肺疾病合并肺栓塞中的诊断价值[J].安徽医药,2018,22(10):1919-1921. |
| D-二聚体联合二氧化碳分压检测在慢性阻塞性肺疾病合并肺栓塞中的诊断价值 |
| Clinical significance of D-dimer and partial pressure detection of carbon dioxide in pulmonary embolism patients with chronic obstructive pulmonary disease |
| 投稿时间：2017-08-02 |
| DOI： |
| 中文关键词: 肺疾病,慢性阻塞性 肺栓塞 脱氧核糖核酸酶(嘧啶二聚体) 血气分析 二氧化碳 早期诊断 |
| 英文关键词: Pulmonary disease,chronic obstructive Pulmonary embolism Deoxyribonuclease (Pyrimidine Dimer) Blood gas analysis Carbon dioxide Early diagnosis |
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| 中文摘要: |
| 目的 探讨D-二聚体(DD)联合二氧化碳分压(PaCO2)检测在慢性阻塞性肺疾病(COPD)合并肺栓塞(PE)中的诊断价值。 方法 收集2015年10月至2017年4月安徽医科大学阜阳临床学院收治COPD患者258例,其中单纯COPD患者228例(COPD组)、COPD合并PE患者30例(COPD并PE组),分别对比一般临床资料、血气分析、凝血功能结果；采用多因素logistic回归分析以上指标与COPD患者是否发生肺栓塞的相关性；比较COPD合并肺栓塞患者中采用方法A[Wells评分(2分法)＞4分]与方法B[DD升高(＞0.5 mg·L-1)联合二氧化碳分压降低(＜35 mmHg)]阳性检出率的差异。 结果 DD:(0.72±0.39)比(1.88±1.13)、纤维蛋白原(FIB):(4.88±1.42)比(5.66±1.29)、PaCO2:(52.12±14.79)比(33.77±6.73)水平在两组之间差异有统计学意义(P＜0.05),其余指标两组间均差异无统计学意义(P＞0.05)；DD升高及PaCO2降低是COPD合并PE的独立危险因素(P＜0.001)；通过配对四格表分析,采用方法A(阳性率为96.67%)与方法B(阳性率为80.00%)在COPD合并PE的阳性检出率相同(χ2=3.200,P=0.074)。 结论 COPD合并PE患者通常合并血栓前高凝及过度通气状态,采用DD升高联合PaCO2降低预测COPD合并PE具有一定的诊断价值。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of D- dimer(DD) combined with carbon dioxide partial pressure(PaCO2) detection in chronic obstructive pulmonary disease(COPD) with pulmonary embolism(PE). Methods Totally 258 patients with COPD treated in Fuyang Clinical College of Anhui Medical University from October 2015 to April 2017 were enrolled in the study,including 228 patients with simple COPD (group of COPD) and 30 patients with COPD combined with PE (group of COPD and PE).The general clinical data,blood gas analysis results and coagulation function of the two groups were compared.Multivariate logistic regression analysis was used to analyze the correlation between the above indexes and the attack of PE in COPD patients.The difference in the positive rate of certain examination was compared between A[Wells detection score(2 points method),＞4] and B[rise of DD(＞0.5 mg·L-1) and decline of PaCO2(＜35 mmHg )]in the COPD patients with PE. Results The levels of DD(0.72±0.39 vs. 1.88±1.13),FIB(4.88±1.42 vs. 5.66±1.29)and PaCO2(52.12±14.79 vs. 33.77±6.73) were statistically significant between the two groups(P＜0.05);the other indicators had no statistically significant differences between the two groups(P＞0.05).The rise of DD and the decline of PaCO2 were independent risk factors of COPD with PE(P＜0.001).According to the analysis of paired fourfold table,the result is significance(χ2=3.200,P=0.074),the positive rate detection results of the A(96.67%)and B(80.00%) methods were the same for COPD patients with PE. Conclusions COPD patients with PE were always manifested with hypercoagulability and hyperventilation state,therefore,the method of judging by the rise of DD combined with the decline of PaCO2 to predict COPD with PE had a certain diagnostic value. |
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