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目的:探讨慢性阻塞性肺疾病(COPD)合并脑梗死(COPD+脑梗死)患者血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)、D-二聚体的临床意义,并观察其与疾病严重度及预后的相关性。方法 :检测COPD+脑梗死患者、COPD患者及健康体检者各40例的血清Hcy、CRP、D-二聚体水平,并测量肺功能、血气分析,采用Logistic回归分析Hcy、高脂血症、高血压病史、CRP、D-二聚体等危险因素与COPD+脑梗死患者临床预后的相关性。结果:COPD+脑梗死组、COPD组Hcy、CRP和D-二聚体水平明显高于对照组(均P<0.01),FEV1、FEV1/FVC及Pa O2则低于对照组(均P<0.01);COPD+脑梗死组Hcy、CRP和D-二聚体水平高于COPD组(均P<0.05),FEV1、FEV1/FVC及Pa O2则低于COPD组(均P<0.01)。COPD+脑梗死组、COPD组Hcy、CRP、D-二聚体水平与FEV1、FEV1/FVC及Pa O2呈负相关(均P<0.05)。Logistic回归分析示高血压、Hcy、CRP及D-二聚体升高是COPD+脑梗死患者住院期间死亡危险因素。结论:COPD合并脑梗死患者血清Hcy、CRP、D-二聚体水平均明显升高,与肺功能(FEV1、FEV1/FVC)呈负相关,高血压、高血清Hcy、CRP、D-二聚体水平为住院期间死亡独立危险因素。
Objective: To investigate the clinical significance of serum homocysteine (Hcy), C-reactive protein (CRP) and D-dimer in patients with chronic obstructive pulmonary disease (COPD) complicated with cerebral infarction (COPD + Correlation of disease severity and prognosis. Methods: Serum levels of Hcy, CRP and D-dimer were measured in 40 COPD patients, COPD patients and healthy volunteers. Pulmonary function and blood gas were measured. Logistic regression analysis was used to analyze Hcy, hyperlipidemia, Blood pressure history, CRP, D-dimer and other risk factors and clinical prognosis of patients with COPD + cerebral infarction. Results: The levels of Hcy, CRP and D-dimer in COPD + COPD group were significantly higher than those in control group (all P <0.01), FEV1, FEV1 / FVC and Pa O2 were lower than those in control group (all P <0.01) ; The levels of Hcy, CRP and D-dimer in COPD + cerebral infarction group were higher than those in COPD group (all P <0.05), FEV1, FEV1 / FVC and Pa O2 were lower than those in COPD group (all P <0.01). The levels of Hcy, CRP and D-dimer in COPD + cerebral infarction group and COPD group were negatively correlated with FEV1, FEV1 / FVC and Pa O2 (all P <0.05). Logistic regression analysis showed that hypertension, Hcy, CRP and D-dimer were risk factors for death during hospitalization in patients with COPD + cerebral infarction. Conclusions: Serum levels of Hcy, CRP and D-dimer in patients with COPD complicated by cerebral infarction were significantly increased, which were negatively correlated with pulmonary function (FEV1, FEV1 / FVC), hypertension, Hcy, CRP, Body level is an independent risk factor for death during hospitalization.