摘要
目的探讨老年慢性阻塞性肺疾病急性发作期（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）合并2型糖尿病患者外周血D-二聚体变化的临床意义,为患者的临床诊治提供实验室依据。方法以我院2013年1月-2015年4月间收治的160例AECOPD合并2型糖尿病的老年患者为研究对象,依据是否合并糖尿病将其分为研究组和对照组。统计分析各组患者入院治疗后第1天、第5天、第10天和第14天时外周血D-二聚体、空腹血糖（fasting blood glucose,FBG）及C-反应蛋白（C-reaction protein,CRP）的水平改变,探讨三种实验室指标间的相关性。结果研究组入院后第1天[（7.15±0.82）vs（2.11±0.23）]、第5天[（6.71±0.78）vs（1.73±0.32）]和第10天[（5.62±1.01）vs（0.85±0.29）]的D-二聚体水平高于对照组,差异具有统计学意义（P〈0.05）。研究组入院后第1天[（157.65±18.41）vs（106.11±13.25）]、第5天[（135.16±13.49）vs（63.24±7.38）]、第10天[（45.73±5.36）vs（9.38±2.14）]的CRP水平高于对照组,差异具有统计学意义（P〈0.05）。研究组入院后第1天[（15.41±3.54）vs（6.39±0.38）]、第5天[（12.63±2.25）vs（5.74±0.51）]、第10天[（8.19±1.76）vs（5.38±0.35）]的FBG水平高于对照组,差异具有统计学意义（P〈0.05）。研究组D-二聚体的水平随着FBG和CRP水平的下降而下降,呈正相关性。结论控制血糖和改善老年AECOPD患者体内炎性反应相关的CRP水平有助于降低D-二聚体水平,提示D-二聚体水平与老年AECOPD合并2型糖尿病患者的病情严重程度呈一定正相关性。
Objective To explore the clinical significance of changes of D-dimer in peripheral blood of elderly patients with AECOPD（acute exacerbation of chronic obstructive pulmonary disease） complicated with type 2 diabetes, so as to provide laboratory basis for the clinical diagnosis and treatment of such disease. Methods A total of 160 elderly patients with AECOPD complicated with type 2 diabetes who were admitted to our hospital from January 2013 to April2015 were selected as research subjects, and were assigned to the research group and control group according to whether diabetes were complicated with. Changes of levels of D-dimer, FBG and CRP in the peripheral blood on the first day, 5th day, 10 th day and 14 th day after the treatment were statistically analyzed in each group of patients, and the correlation between the three laboratory indicators was investigated. Results The levels of D-dimer in the research group on the first day, 5th day and 10 th day after hospitalization were [（7.15±0.82） vs（2.11±0.23）], [（6.71±0.78） vs（1.73±0.32）] and [（5.62±1.01） vs（0.85±0.29）] respectively, all higher than those in the control group, and the differences were statistically significant（P〈0.05）. The CRP levels in the research group on the first day, 5th day and 10 th day after hospitalization were [（157.65 ±18.41） vs（106.11 ±13.25）], [（135.16 ±13.49） vs（63.24 ±7.38）] and [（45.73 ±5.36） vs（9.38 ±2.14）] respectively, all higher than those in the control group, and the differences were statistically significant（P〈0.05）.The FBG levels in the research group on the first day, 5th day and 10 th day after hospitalization were [（15.41±3.54） vs（6.39±0.38）], [（12.63±2.25） vs（5.74±0.51）] and [（8.19±1.76） vs（5.38±0.35）] respectively, and the differences were statisti cally significant（P〈0.05）. In the research group, the level of D-dimer was reduced along with the reducing of FBG and CRP levels, with positive correlation. Conclusion Blood sugar control and improvement of CRP level associated with inflammatory reaction in elderly patients with AECOPD help reduce the level of D-dimer, indicating that D-dimer is positively correlated with the disease severity for the elderly patients with AECOPD complicated with type 2 diabetes.
出处
《中国现代医生》
2015年第33期80-82,86,共4页
China Modern Doctor
