慢性阻塞性肺疾病急性加重期合并深静脉血栓的研究  

Study of acute exacerbation of chronic obstructive pulmonary disease complicated with deep venous thrombosis

作　　者：张筠[1] 张铁栓[1] ZHANG Yun;ZHANG Tie-shuan(Department of Respiratory Medicine,The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院呼吸内科,河南郑州450014

出　　处：《医药论坛杂志》2020年第6期33-36,共4页Journal of Medical Forum

摘　　要：目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者合并深静脉血栓(DVT)的临床特点及低氧血症、D-二聚体、血浆凝血因子Ⅷ在其中的意义。方法采取前瞻性描述性研究连续纳入AECOPD患者共103例,入院24小时内即行双上肢及双下肢静脉血管彩色多普勒超声,根据结果分为DVT组和无DVT组。对比DVT组和无DVT组患者在临床特点即性别、年龄、体重指数、动脉血氧分压、是否使用无创呼吸机辅助通气及总住院时间上有无统计学差异,同时比较DVT组和无DVT组患者在实验室检查中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、D-二聚体及凝血因子Ⅷ水平上有无统计学差异。结果103例AECOPD患者中,11例(10.7%)合并DVT,92例(89.3%)未合并DVT。DVT组与无DVT组相比较,DVT组患者低氧血症明显增多,住院时间明显延长,使用无创呼吸机辅助通气比例明显升高,DVT组患者凝血因子Ⅷ水平及D-二聚体水平均较无DVT组患者高,且差异均具有统计学意义(P<0.05),而在性别、年龄、体重指数方面及PT、APTT、Fbg水平上两组间并无统计学差异。结论低氧血症、D-二聚体及凝血因子Ⅷ水平升高的AECOPD患者更易发生DVT,并且AECOPD合并DVT患者使用无创呼吸机辅助通气比例升高,住院时间延长。Objective To investigate the clinical characteristics and the significance of Hypoxemia andⅧfactor of deep venous thrombosis(DVT)in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods One hundred and three patients with acute exacerbation of COPD were consecutively included.Color Doppler ultrasound examination of extremities was performed for diagnosing DVT in all cases Within 24 hours of admission.The patients with DVT were compared with those without DVT in clinical characteristics and laboratory examination includingⅧfactor.Results Among one hundred and three patients with acute exacerbation of COPD,DVT was detected in 11 cases(10.7%).In the COPD patients with DVT,the hypoxia was more,the duration of hospitalization was longer and the mechanical ventilation requirement increased compared those without DVT.The D-dimer andⅧfactor levels were significantly higher in the COPD patients with DVT than those without DVT(P<0.05).Conclusion The patients with acute exacerbation of COPD have a higher risk of DVT when hypoxia or having a high levels of D-dimer andⅧfactor,and the proportion of non-invasive mechanical ventilation was increased and the hospitalization time was prolonged.

关 键 词：慢性阻塞性肺疾病 深静脉血栓 低氧血症 凝血因子Ⅷ 

分 类 号：R563[医药卫生—呼吸系统]