文章摘要
武红莉,田瑞雪,叶青,曹霞,宋育佳.慢性阻塞性肺疾病急性加重期伴肺栓塞的危险因素及临床特征[J].中国临床保健杂志,2018,21(2):251-254.
慢性阻塞性肺疾病急性加重期伴肺栓塞的危险因素及临床特征
Risk factors and clinical characteristics analysis of acute exacerbation of chronic obstructive pulmonary disease with pulmonary embolism
投稿时间:2017-09-26  
DOI:10.3969/J.issn.1672-6790.2018.02.029
中文关键词: 慢性阻塞性肺疾病急性加重期  肺栓塞  危险因素  临床特征
英文关键词: Acute obstructive pulmonary disease Acute exacerbation  Pulmonary embolism  Risk factors  Clinical features
基金项目:
作者单位E-mail
武红莉 北京市海淀医院呼吸科,100080 thank721@sina.com 
田瑞雪 北京市海淀医院呼吸科,100080  
叶青 北京市海淀医院呼吸科,100080  
曹霞 北京市海淀医院呼吸科,100080  
宋育佳 北京市海淀医院呼吸科,100080  
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中文摘要:
      目的 探讨慢性阻塞性肺疾病(COPD)急性加重期伴肺栓塞的危险因素及临床特征分析。方法回顾性分析肺动脉造影确诊的慢性阻塞性肺疾病急性加重期患者126例,其中56例伴发肺栓塞(观察组),70例未并发肺栓塞(对照组),通过对比分析两组患者临床特征进行单因素分析,再行logistic多因素回归分析。结果 观察组患者晕厥发生率(23.2%)高于对照组(2.9%),且下肢非对称性肿胀≥1 cm(46.4%)、下肢深静脉血栓形成(53.6%)、卧床时间≥7 d(66.1%)、6周内手术史/骨折史(23.2%)及静脉血栓史(39.3%)发生率均显著高于非肺栓塞组(12.9%、12.9%、38.6%、5.2%、11.4%),组间差异有统计学意义(P<0.05);观察组肺动脉收缩压(SPAP)、血浆D-二聚体水平(D-dimer)、二氧化碳分压(PaCO2)水平高于对照组,组间差异有统计学意义(P<0.05),且观察组SIQⅢTⅢ综合征和ST段改变发生率明显高于对照组,组间差异有统计学意义(P<0.05)。晕厥和6周内手术史/骨折史均为COPD急发作期并发肺栓塞的独立危险因素(P<0.05)。结论 COPD急性加重期患者晕厥和6周内手术史/骨折史均为COPD急发作期并发肺栓塞的独立危险因素,且当患者症状加重,出现晕厥、心电图表现SIQⅢTⅢ综合征以及SPAP、D-dimer、PaCO2水平升高时,应警惕肺栓塞可能。
英文摘要:
      Objective To study the risk factors and clinical characteristics of acute obstructive pulmonary disease with pulmonary obstruction.Methods A retrospective analysis of pulmonary angiography confirmed acute exacerbation of chronic obstructive pulmonary disease in 126 patients,56 cases with pulmonary embolism as the observation group,the remaining 70 cases as the control group,to analyse the clinical characteristics of the two groups of patients by univariate analysis and logistic multivariate regression analysis.Results The incidence of syncope was significantly higher in the observation group than that in the control group (23.2% VS.2.9%).The asymmetry of lower extremity was ≥1 cm (46.4%),deep venous thrombosis of lower extremity (53.6%),bedtime ≥7d (66.1%),history of history and history of fracture (23.2%) and history of venous thrombosis (39.3%) were significantly higher than those in non-pulmonary embolism group (12.9%,12.9%,38.6%,5.2% and 11.4%,P<0.05).The level of SPAP,D-dimer and PaCO2 in the observation group was significantly higher than that in the control group (P<0.05),and the incidence of SIQⅢTⅢ syndrome and ST-segment were significantly higher in the observation group than in the control group,The difference between the two groups was significant (P<0.05).Logistic multivariate regression analysis showed that incidence of syncope and venous thrombosis were independent risk factors for COPD emergency episodes with pulmonary embolism.Conclusion The patients with acute exacerbation of COPD had ≥7d bedtime,deep venous thrombosis and asymmetric swelling of both lower extremities ≥1cm and venous thrombosis are associated with high risk factors associated with pulmonary embolism.When the symptoms aggravated with syncope,SIQⅢTⅢs and high SPAP,D-dimer and PaCO2 levels,the patients should be alert to pulmonary embolism.
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