D二聚体检测在慢性阻塞性肺疾病三级预防中意义.docVIP

D二聚体检测在慢性阻塞性肺疾病三级预防中意义 　　摘 要 目的：分析慢性阻塞性肺疾病（COPD）稳定期及急性加重期（AECOPD）患者血浆D-二聚体水平，探讨其在COPD三级预防中的应用。方法：收集2012年6月-2014年6月中心收治的COPD稳定期患者50例和急性加重期患者52例，检测血浆D-二聚体水平，并与50名正常者（对照组）进行比较。结果：急性加重期组的D-二聚体水平为1.02 mg/L，明显高于稳定期组的0.57 mg/L（P0.05）和对照组的0.42 mg/L（P0.001）。结论：COPD稳定期及急性加重期患者血浆D-二聚体水平均高于正常人群，更易出现高凝状态，D-二聚体检测对COPD患者的三级预防有指导意义。 　　关键词 慢性阻塞性肺疾病 D-二聚体 三级预防 　　中图分类号：R563 文献标识码：A 文章编号：1006-1533（2015）20-0029-02 　　The significance of the detection of D-dimer in patients with chronic obstructive pulmonary disease for tertiary prevention 　　ZHAI Jiayi 　　（Jiading Community Health Service Center of Jiading District， Shanghai 201800， China） 　　ABSTRACT Objective： To analyze the plasma D-dimer level in the patients with chronic obstructive pulmonary disease （COPD） in the stable phase and acute exacerbation of chronic obstructive pulmonary disease （AECOPD） to explore its application in the tertiary prevention. Methods： From June 2012 to June 2014， 50 patients with COPD in the stable phase and 52 ones with AECOPD treated in the center were collected and the level of D-dimer was detected， which was compared with that in 50 healthy people （in the control group）. Results： The level of D-dimer in the AECOPD patents was 1.02 mg/L which was significantly higher than 0.57 mg/L in the group of COPD in the stable phase （P0.05） and 0.42 mg/L in the control group（P0.05）. Conclusion： The levels of D-dimer in the patients with COPD in the stable phase and AECOPD were higher than that in the normal population， which is easier to appear hypercoagulability. The detection of D-dimer has the guiding significance for the tertiary prevention in the COPD patients. 　　KEY WORDS chronic obstructive pulmonary disease； D-dimer； tertiary prevention 　　目前，在社区全科医疗体系中强调以人的健康为中心，以家庭为单位，以街道为基本范围，集健康教育、预防、保健、康复、计划生育、基本医疗为一体的“六位一体”为社区卫生特色服务。慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）是一种气流受限不完全可逆，呈进行性发展的呼吸系统疾病。COPD诊治指南（2013年修订版）[1]指出，我国COPD患病率占40岁以上人群的8.2%。第六次人口普查中，嘉定区人口老龄化程度位列上海市第二位[2]，嘉定镇地区同样位于前列。因此，以“六位一体”方