中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2014年
24期
22-25
,共4页
慢性阻塞性肺病急性加重期%动态监测%C反应蛋白%D-二聚体%血气分析
慢性阻塞性肺病急性加重期%動態鑑測%C反應蛋白%D-二聚體%血氣分析
만성조새성폐병급성가중기%동태감측%C반응단백%D-이취체%혈기분석
Acute exacerbations chronic obstructive lung disease%Dynamic monitoring%C-reactive protein%D-dimer%Blood gas analysis
目的：通过动态检测慢性阻塞性肺病急性加重期（AECOPD）患者C反应蛋白、D-二聚体变化和血气分析的变化，探讨其在AECOPD临床治疗中的意义。方法对我院2013年1月~2014年1月入院治疗的70例AECOPD患者和60例健康体检患者动态监测其C反应蛋白、D-二聚体变化和血气分析的变化，给予AECOPD患者适当治疗（包括纠正缺氧、解痉和抗凝药物），比较AECOPD患者治疗前C反应蛋白、D-二聚体变化在治疗后患者和健康患者中水平的差异；比较ACEOPD患者治疗前后血气分析水平差异；比较好转患者与死亡患者治疗前后C反应蛋白、D-二聚体变化的差异，观察其对AECOPD临床诊疗的影响。结果AECOPD患者治疗前C反应蛋白水平为（133.46±12.85）mg/L，显著高于治疗后（8.12±5.61）mg/L（P＜0.05）和健康患者（3.15±2.43）mg/L（P＜0.05）；AECOPD患者治疗前D-二聚体水平为（3.58±0.26）mg/L，显著高于治疗后（0.57±0.18）mg/L（P＜0.05）和健康患者（0.33±0.74）mg/L（P＜0.05）；血气分析结果显示AECOPD患者治疗前后D-二聚体与动脉血氧分压( PaO2)呈显著负相关（r=-0.562, P＜005）,与动脉血二氧化碳分压( PaCO2)呈显著正相关（r=0.683, P＜0.05）；AECOPD患者治疗后有62例（88.5%）患者好转，8例（11.4%）患者死亡，死亡组患者治疗后C反应蛋白（159.87±7.90）mg/L、D-二聚体（5.57±0.35）mg/L水平较治疗前（147.43±15.65）mg/L、（4.76±0.42）mg/L显著升高（均P＜0.05）。结论动态监测C反应蛋白、D-二聚体变化和血气分析可早期判断COPD加重情况，对疾病控制也预后有重要意义，患者缺氧或有高碳酸血症对D-二聚体增高起关键作用。
目的：通過動態檢測慢性阻塞性肺病急性加重期（AECOPD）患者C反應蛋白、D-二聚體變化和血氣分析的變化，探討其在AECOPD臨床治療中的意義。方法對我院2013年1月~2014年1月入院治療的70例AECOPD患者和60例健康體檢患者動態鑑測其C反應蛋白、D-二聚體變化和血氣分析的變化，給予AECOPD患者適噹治療（包括糾正缺氧、解痙和抗凝藥物），比較AECOPD患者治療前C反應蛋白、D-二聚體變化在治療後患者和健康患者中水平的差異；比較ACEOPD患者治療前後血氣分析水平差異；比較好轉患者與死亡患者治療前後C反應蛋白、D-二聚體變化的差異，觀察其對AECOPD臨床診療的影響。結果AECOPD患者治療前C反應蛋白水平為（133.46±12.85）mg/L，顯著高于治療後（8.12±5.61）mg/L（P＜0.05）和健康患者（3.15±2.43）mg/L（P＜0.05）；AECOPD患者治療前D-二聚體水平為（3.58±0.26）mg/L，顯著高于治療後（0.57±0.18）mg/L（P＜0.05）和健康患者（0.33±0.74）mg/L（P＜0.05）；血氣分析結果顯示AECOPD患者治療前後D-二聚體與動脈血氧分壓( PaO2)呈顯著負相關（r=-0.562, P＜005）,與動脈血二氧化碳分壓( PaCO2)呈顯著正相關（r=0.683, P＜0.05）；AECOPD患者治療後有62例（88.5%）患者好轉，8例（11.4%）患者死亡，死亡組患者治療後C反應蛋白（159.87±7.90）mg/L、D-二聚體（5.57±0.35）mg/L水平較治療前（147.43±15.65）mg/L、（4.76±0.42）mg/L顯著升高（均P＜0.05）。結論動態鑑測C反應蛋白、D-二聚體變化和血氣分析可早期判斷COPD加重情況，對疾病控製也預後有重要意義，患者缺氧或有高碳痠血癥對D-二聚體增高起關鍵作用。
목적：통과동태검측만성조새성폐병급성가중기（AECOPD）환자C반응단백、D-이취체변화화혈기분석적변화，탐토기재AECOPD림상치료중적의의。방법대아원2013년1월~2014년1월입원치료적70례AECOPD환자화60례건강체검환자동태감측기C반응단백、D-이취체변화화혈기분석적변화，급여AECOPD환자괄당치료（포괄규정결양、해경화항응약물），비교AECOPD환자치료전C반응단백、D-이취체변화재치료후환자화건강환자중수평적차이；비교ACEOPD환자치료전후혈기분석수평차이；비교호전환자여사망환자치료전후C반응단백、D-이취체변화적차이，관찰기대AECOPD림상진료적영향。결과AECOPD환자치료전C반응단백수평위（133.46±12.85）mg/L，현저고우치료후（8.12±5.61）mg/L（P＜0.05）화건강환자（3.15±2.43）mg/L（P＜0.05）；AECOPD환자치료전D-이취체수평위（3.58±0.26）mg/L，현저고우치료후（0.57±0.18）mg/L（P＜0.05）화건강환자（0.33±0.74）mg/L（P＜0.05）；혈기분석결과현시AECOPD환자치료전후D-이취체여동맥혈양분압( PaO2)정현저부상관（r=-0.562, P＜005）,여동맥혈이양화탄분압( PaCO2)정현저정상관（r=0.683, P＜0.05）；AECOPD환자치료후유62례（88.5%）환자호전，8례（11.4%）환자사망，사망조환자치료후C반응단백（159.87±7.90）mg/L、D-이취체（5.57±0.35）mg/L수평교치료전（147.43±15.65）mg/L、（4.76±0.42）mg/L현저승고（균P＜0.05）。결론동태감측C반응단백、D-이취체변화화혈기분석가조기판단COPD가중정황，대질병공제야예후유중요의의，환자결양혹유고탄산혈증대D-이취체증고기관건작용。
Objective To test the level of CRP、D-dimer and blood gas analysis in patients with acute exacerbations chronic obstructive lung disease by dynamic monitoring and explore it's clinical significance for patients with acute exacerbations chronic obstructive lung disease. Methods 70 patients with acute exacerbations chronic obstructive lung disease in our hospital from January 2012 to January 2013 and 60 health examination patients were tested the level of CRP、D-dimer and blood gas analysis by Dynamic monitoring, patients with acute exacerbations chronic obstructive lung disease were treated by correction of hypoxia, spasmolysis and anticoagulant drugs. The different of the level of CRP and D-dimer in patients with acute exacerbations chronic obstructive lung disease between before treatment and after treatment and health examination patients were compared. The different of blood gas analysis between before treatment and after treatment were compared. The different of the level of CRP and D-dimer between improved patients and dead patients were compared and the clinical significance for patients with chronic obstructive lung disease was observed. Results The level of CRP in patients with acute exacerbations chronic obstructive lung disease between before was (133.46±12.85)mg/L and significant higher than that in patients after treatment(8.12±5.61)mg/L and health examination patients(3.15±2.43)mg/L (all P < 0.05);the level of D-dimer in patients with acute exacerbations chronic obstructive lung disease between before was (3.58±0.26)mg/L and significant higher than that in patients after treatment(0.57±0.18)mg/L and health examination patients(0.33±0.74)mg/L ( P < 0 . 0 5 ) . t h e outcome of blood gas analysis showed that there was a negative correlation between D-dimer with arterial blood oxygen partial pressure(PaO2)(r=-0.562, P<005) and there was a positive correlation between D-dimer with partial carbon dioxide pressure(PaCO2)(r=0.683, P<0.05). There was 62(88.5%) proved patients and 8 (11.4%) dead patients after treatment, the he level of CRP[(159.87±7.90)mg/L ]and D-dimer [(5.57±0.35)mg/L ]in dead patients were significant higher than the level of CRP [(147.43±15.65)mg/L ] and D-dimer [(4.76±0.42)mg/L ] before treatment(P < 0.05). Conclusion Dynamic monitoring for the level of CRP、D-dimer in patients with chronic obstructive lung disease can judge the worse situation of chronic obstructive lung disease, there has a important significance for prognosis disease, and patients with hypoxia or hypercapnia play a key role in D-dimer increased.
