慢性阻塞性肺疾病急性发作住院患者发生静脉血栓栓塞症的危险因素研究  

Risk Factors of Venous Thromboembolism in Inpatients with Acute Onset of Chronic Obstructive Pulmonary Disease

作　　者：胡碧江[1] 陈建南[1] 陈文腾[1] 丁毅鹏[1] 

机构地区：[1]海南省人民医院急救中心,海南省海口市570311

出　　处：《中国全科医学》2013年第19期2236-2238,共3页Chinese General Practice

摘　　要：目的探讨因急性发作住院的慢性阻塞性肺疾病(COPD)患者住院期间发生静脉血栓栓塞症(VTE)的危险因素。方法纳入2008年6月—2011年12月我院收治的因急性发作而住院的COPD患者,采用回顾性分析方法,选择符合纳入标准的患者资料,按是否发生VTE分为VTE组和非VTE组。对患者基本资料、相关临床特征、临床指标比较后进行Logistic多元回归分析。结果共纳入患者706人,其中VTE发生率为15.2%(107/706)。VTE组男性比例、房性纤颤发生率低于非VTE组,查尔森合并症指数(CCI)>2、卧床无法行动、胸痛、下肢疼痛、肿瘤、昏厥的比例及住院天数高于非VTE组,D-二聚体水平高于非VTE组,差异均有统计学意义(P<0.05)。将上述指标进行多元回归分析发现危险因素分别为男性〔OR=1.775,95%CI(1.658,1.901),P=0.00〕;肿瘤〔OR=2.932,95%CI(2.699,3.163),P=0.00〕;动脉疾病〔OR=1.174,95%CI(1.015,1.365),P=0.04〕;D-二聚体升高〔OR=2.613,95%CI(2.135,2.953),P=0.00〕。结论 COPD急性发作住院患者VTE发生率较高,男性、肿瘤、动脉疾病、D-二聚体水平升高的患者值得临床医师注意,可考虑行常规抗凝治疗。Objective To investigate the risk factors of venous thromboembolism （VTE） in hospitalized patients with acute episode of chronic obstructive pulmonary disease （COPD）. Methods The retrospective analysis was used to analyze the data of COPD patients admitted to our hospital from June 2008 to December 2011 because of acute exacerbation and met the inclu- sive criteria. The inpatients were divided as VTE group and non - VTE group according to VTE occurrence. Logistic multivariate regression analysis was conducted about basic data, clinical features, and clinical indicators after comparison between the two groups. Results Totally 706 patients were included, with an incidence of 15.2% （107/706） for VTE. Compared with non - VTE group, in VTE group the ratio of males, atrial fibrillation were lower, the proportion of Charlson comorbidity index （CCI） index 〉 2 was higher, the proportions of longer hospitalization period, bed rest, chest pain, lower limb pain, tumor, syncope were all higher; and the two D - dimer was also higher. All the differences between the two groups were statistically significant （P 〈0. 05）. Logistic multivariate regression analysis showed that the risk factors were male [ OR = 1. 775, 95% CI （ 1,658, 1.901）, P=0.00], tumor [OR =2.932, 95%CI （2.699, 3. 163）, P=0.001, artery disease [0R=1.174, 95%CI （1.015, 1.365）, P=0.04], and increased D-dimer [OR =2.613, 95%CI （2. 135, 2.953）, P =0.001. Conclusion The incidence of VTE in hospitalized patients with acute episode of chronic obstructive pulmonary disease is higher. It is necessary for clinicians to pay attention to patients who are male, or have tumor, artery disease, increased D - dimer level, and a routine anticoagulation therapy may be considered.

关 键 词：肺疾病 慢性阻塞性 静脉血栓栓塞症 深静脉血栓 肺血栓栓塞症 危险因素 

分 类 号：R563[医药卫生—呼吸系统]