慢性阻塞性肺疾病合并急性肺栓塞患者乳酸脱氢酶及D-二聚体变化

目的 观察慢性阻塞性肺疾病急性加重(AECOPD)患者及慢性阻塞性肺疾病合并急性肺血栓栓塞(COPD with PTE)患者乳酸脱氢酶(LDH)及D-二聚体(D-D)变化,了解其对肺栓塞的诊断价值.方法 40例AECOPD患者,40例COPD合并PTE患者,40例对照者来自2009年9月~2011年12月河南科技大学第一附属医院.结果 COPD合并PTE组LDH、D-D、纤维蛋白原(Fbg)、天冬氨酸转氨酶(AST)[(363.0±105.0) U/L、(618.0±198.0) μg/L、(5.1±1.5) g/L、(69.0±49.0) U/L ]明显高于COPD[(294.0±12.0) U/L、(500.0±271.0) μg/L、(4.2±1.4) g/L、(55.0±37.0) U/L ]和正常对照组[(135.0±49.0) U/L、(241.0±113.0) μg/L、(3.0±0.9) g/L、(35.0±20.0) U/L](P＜0.05).当LDH诊断临界值为295.0 U/L时,COPD合并PTE诊断灵敏度为73.1%,特异度为80.0%.当D-D诊断临界值为550.0 μg/L时,COPD合并PTE诊断灵敏度为80.8%,特异度为76.7%.结论 COPD合并PTE患者血清D-D、Fbg、LDH水平明显升高,检测患者血清D-D、Fbg、LDH可为诊断COPD合并PTE提供参考.

Changes of Lactic Dehydrogenase and D-dimer in Chronic Obstructive Pulmonary Disease Patients with Acute Pulmonary Thromboembolism

Objective To investigate the changes of lactic dehydrogenase lactic delydrogenase(LDH) and D-dimer(D-D) in chronic obstructive pulmonary disease patients with acute pulmonary thromboembolism and patients with chronic obstructive pulmonary disease.The relationships between these changes and PTE were evaluated. Methods All objects enrolled were from the First Affiliated Hospital of Henan University of Science and Technology. Results The values of LDH,D-D,Fbg and AST in COPD with PTE [(363.0±105.0) U/L,(618.0±198.0) μg/L,(5.1±1.5) g/L,(69.0±49.0) U/L] were significantly higher than those in AECOPD[(294.0±12.0) U/L,(500.0±271.0) μg/L,(4.2±1.4) g/L,(55.0±37.0) U/L ]and control group[(135.0±49.0) U/L,(241.0±113.0) μg/L,(3.0±0.9) g/L,(35.0±20.0) U/L](P<0.05).When cutoff point of LDH was 295.0 U/L,the sensitivity and specificity of COPD with PTE were 73.1% and 80.0%.When cutoff point of D-D was 295.0 U/L,the sensitivity and specificity of COPD with PTE were 80.8% and 76.7%. Conclusion The values of senlm D-D,Fbg,LDH and AST are significantly increased in COPD with PTE.These changes may be useful in the risk stratification of COPD with PTE patients.