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目的观察慢性阻塞性肺疾病急性加重(AECOPD)及慢性阻塞性肺疾病合并急性肺血栓栓塞(COPD with PTE)患者前列环素(PGI2)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2012年9月~2014年12月南阳市第二人民医院。结果 COPD合并PTE组D-D、纤维蛋白原(FIB)、天冬氨酸转氨酶(AST)[(618±198μg/L)、(513±147mg/dL)、(69±49U/L)]明显高于AECOPD[(500±271μg/L)、(423±144mg/dL)、(55±37U/L)]和正常对照组[(241±113μg/L)、(303±85mg/dL)、(35±20U/L)](P<0.05)而COPD合并PTE组前列环素(PGI2)(74.2±19.2μg/L)明显低于AECOPD(85.5±24.3μg/L)和正常对照组(108.6±17.1μg/L)(P<0.05),当PGI2诊断临界值为敏度为80.0%,特异度为69.3%。当D-D诊断临界值为550ug/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PGI2明显降低、DD、FIB明显升高。COPD患者血清PGI2明显降低、D-D、FIB明显升高常提示COPD合并PTE可能。
Objective To observe the changes of prostacyclin (PGI2) and D-dimer (DD) in patients with acute obstructive pulmonary disease (AECOPD) and chronic obstructive pulmonary disease (COPD) and acute pulmonary embolism (COPD) Diagnostic value of embolism. Methods Forty patients with AECOPD, 40 patients with COPD and PTE and 40 controls were from September 2012 to December 2014 in Nanyang Second People’s Hospital. Results The levels of DD, fibrinogen (FIB) and aspartate aminotransferase (AST) [(618 ± 198μg / L), (513 ± 147mg / dL) and (69 ± 49U / L)] in COPD group were significantly higher than those in PTE group AECOPD [(500 ± 271μg / L), (423 ± 144mg / dL), (55 ± 37U / L)] and normal control group (241 ± 113μg / L), (303 ± 85mg / dL) (P <0.05). However, PGI2 (74.2 ± 19.2μg / L) in COPD group was lower than that in AECOPD group (85.5 ± 24.3μg / L) and normal control group (108.6 ± 17.1μg / L) /L)(P<0.05). When the critical value of PGI2 diagnosis was 80.0%, the specificity was 69.3%. When the D-D diagnostic threshold was 550ug / L, the diagnostic sensitivity of COPD combined with PTE was 80.8% and the specificity was 76.7%. Conclusion Serum PGI2 in patients with COPD and PTE is significantly lower, and DD and FIB are significantly higher. Serum PGI2 was significantly lower in patients with COPD, D-D, FIB significantly increased often prompted the possibility of COPD with PTE.