血清同型半胱氨酸、C反应蛋白、D-二聚体、纤维蛋白原水平与慢性阻塞性肺疾病合并脑梗死的临床意义

Clinical significance of serum homocysteine,C reactive protein,D-two dimer and fibrinogen level in patients with chronic obstructive pulmonary disease combined with cerebral infarction

目的探讨血清同型半胱氨酸、C反应蛋白(CRP)、D-二聚体、纤维蛋白原水平与慢性阻塞性肺疾病合并脑梗死的临床意义。方法选取2015年1月~2016年12月我院收治的慢性阻塞性肺疾病(COPD)合并脑梗死患者70例(COPD+脑梗死组)、慢性阻塞性肺疾病患者85例(COPD组)及同期健康体检者65例为对照。检测三组血清Hcy、CRP、D-二聚体、纤维蛋白原水平,对三组进行血气分析及肺功能检查。采用Pearson相关性分析COPD+脑梗死患者临床预后与高血脂症、高血压病史、Hcy、CRP、D-二聚体、纤维蛋白原等危险因素的相关性。结果 COPD+脑梗死组血清Hcy、CRP、D-二聚体、纤维蛋白原水平均较COPD组和对照组高,差异有统计学意义(P<0.01);COPD组血清Hcy、CRP、D-二聚体、纤维蛋白原水平均较对照组高,差异有统计学意义(P<0.01);COPD组、COPD+脑梗死组血清CRP、Hcy、纤维蛋白原、D-二聚体与Pa O2和FEV1、FEV1/FVC呈负相关(P<0.05)。结论 COPD合并脑梗死患者血清CRP、Hcy、纤维蛋白原、D-二聚体水平显著升高,与Pa O2和肺功能指标(FEV1、FEV1/FVC)呈负相关。在COPD合并脑梗死的临床治疗过程中,一旦发现血清Hcy、CRP、D-二聚体、纤维蛋白原水平迅速升高,则需鉴定患者是否存在脑梗死情况,并根据病情给予相应的早期干预,避免患者病情恶化。

Objective To explore the clinical significance of serum homocysteine(Hcy),C reactive protein(CRP),Dtwo dimer and fibrinogen level in patients with chronic obstructive pulmonary disease combined with cerebral infarction.Methods From January 2015 to December 2016,70 patients with chronic obstructive pulmonary disease(COPD)combined with cerebral infarction(COPD+cerebral infarction group)in our hospital,85 cases of chronic obstructive pulmonary disease(COPD group)and 65 cases of healthy physical examination at the same time were selected.Serum levels of Hcy,CRP,D-two dimmer and fibrinogen in three groups were detected.Blood gas analysis and pulmonary function test were performed in three groups.The correlation between the clinical prognosis of COPD+cerebral infarction and the risk factors of hyperlipidemia,hypertension,Hcy,CRP,D-two dimmer,fibrinogen and so on were retrospectively analyzed by Logistic.Results The levels of serum Hcy,CRP,D-two dimmer and fibrinogen in COPD+cerebral infarction group were higher than those in COPD group and control group(P<0.01).The serum levels of Hcy,CRP,D-two dimmer and fibrinogen in COPD group were higher than those in the control group,the difference was statistically significant(P<0.01).Serum CRP,Hcy,fibrinogen and D-two dimmer in COPD group and COPD+cerebral infarction group were negatively correlated with PaO2,FEV1 and FEV1/FVC(P<0.05).Conclusion The levels of serum CRP,Hcy,fibrinogen and D-two dimmer in patients with COPD+cerebral infarction increased significantly,and were negatively correlated with PaO2 and lung function index(FEV1,FEV1/FVC).In the treatment process of COPD combined with cerebral infarction,once the serum levels of Hcy,CRP,D-two dimmer,and fibrinogen are rapidly increased,it is necessary to identify the presence of cerebral infarction and to give early intervention according to the condition,and to avoid the deterioration of the patient's condition.