慢性阻塞性肺疾病急性加重期合并深静脉血栓形成危险因素及抗凝因子检测  

Risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease combined with deep venous thrombosis

作　　者：孙建英[1] 刘飒[1] 王红阳[1] 刘晨[1] 刘新茹[1] 贾红光[1] 

机构地区：[1]华北煤炭医学院附属医院呼吸内科,唐山063000

出　　处：《中国医师进修杂志》2010年第19期1-3,共3页Chinese Journal of Postgraduates of Medicine

基　　金：基金项目：河北省医学科研重点课题（08412）

摘　　要：目的 分析慢性阻塞性肺疾病急性加重期（AECOPD）合并深静脉血栓形成（DVT）患者的相关危险因素及抗凝因子变化.方法 110例AECOPD患者按下肢深静脉超声结果分为DVT组和非DVT组,对比分析其危险因素及抗凝指标.结果 110例AECOPD患者中,确诊DVT 12例（10.9%）,合并肺血栓栓塞症2例（1.8%）.与非DVT组比较,DVT组卧床〉3 d、吸烟、机械通气的例数增多及住院时间延长（P〈0.01）,动脉血二氧化碳分压（PaCO2）增高（P〈0.05）;抗凝血酶Ⅲ活性、蛋白S含量下降（P〈0.05）及血D-二聚体含量增加（P〈0.05）.结论 造成AECOPD患者制动的因素如长期卧床及吸烟、机械通气是发生DVT的高危因素;且Ⅱ型呼吸衰竭的患者更容易合并DVT;AECOPD合并DVT患者存在纤溶功能失衡状态,应监测纤溶指标变化.Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） combined with deep venous thrombosis （DVT）. Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities： DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases （10.9%） were in DVT group,of whom 2 cases （1.8%）had pulmonary embolism. The rate of lying in bed 〉 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group （P 〈 0.01 or 〈0.05 ）. In DVT group, the activity of antithrombin Ⅲ and the level of protein S decreased （P 〈 0.05 ）, and the level of D-Dimer increased （P 〈 0.05）. Conclusions Long-term bed, smoke and mechanical ventilation requirement are the main risk factors of DVT in patients with AECOPD. Respiratory failure （type Ⅱ ） is easier to combine with DVT. Abnormality of coagulation and fibrinolytic system exists in AECOPD with DVT.

关 键 词：肺疾病 慢性阻塞性 静脉血栓形成 肺栓塞 血液凝固 

分 类 号：R563[医药卫生—呼吸系统]