慢性阻塞性肺疾病急性加重合并下肢深静脉血栓的临床特征及危险因素  

The clinical characteristics and risk factors of acute exacerbations of chronic obstructive pulmonary disease combined with deep venous thrombosis

作　　者：岳晓艳 李凤杰[1] 蒋志锋[1] 朱娅楠 Yue Xiaoyan;Li Fengjie;Jiang Zhifeng;Zhu Yanan(Department of Emergency,Beijing Luhe Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京潞河医院急诊科,北京100069

出　　处：《首都医科大学学报》2021年第1期153-157,共5页Journal of Capital Medical University

摘　　要：目的探讨慢性阻塞性肺疾病急性加重(acute exacerbation chronic obstructive pulmonary disease,AECOPD)患者合并下肢深静脉血栓(deep venous thrombosis,DVT)的危险因素。方法连续收集2018年10月至2019年4月首都医科大学附属北京潞河医院急诊病房收治的AECOPD患者51例,根据入院后下肢静脉彩色多普勒超声回报有无血栓的结果,分为血栓组和非血栓组,比较两组患者的基本资料、临床特征及检查结果。结果在有无下肢水肿、肺动脉高压、平均动脉压、D-二聚体方面两组患者之间差异有统计学意义(均P<0.05),对单因素分析结果中有意义的因素行多因素Logistic回归分析,结果显示,下肢水肿、肺动脉高压是AECOPD合并DVT的独立危险因素(P<0.05,OR=5.215,3.741),而平均动脉压及D-二聚体不是AECOPD合并DVT的独立危险因素(P>0.05)。两组患者的C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、肿瘤坏死因子(tumor necrosis factor,TNF)、动脉血氧分压之间差异无统计学意义(P>0.05)。结论对AECOPD患者可通过下肢水肿情况、肺动脉高压推断发生下肢静脉血栓的可能性,进而针对性地检查、治疗,达到诊断及预防下肢深静脉血栓的效果。Objective To investigate the risk factors of deep venous thrombosis(DVT)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 51 patients with AECOPD admitted to the emergency ward of our hospital from October 2018 to April 2019 were collected and divided into the thrombotic group and the non-thrombotic group according to the results of lower extremity vein color Doppler ultrasound report after admission,and the basic data,clinical characteristics and examination results of the two groups were compared.Results In the presence of lower extremity edema,pulmonary hypertension,average pressure,D-dimer of significant differences between the two groups of patients(P<0.05),the results of single factor analysis of meaningful factors multivariable Logistic regression analysis,the results show lower extremity edema and pulmonary hypertension are AECOPD combined independent risk factors for DVT(P<0.05,OR=5.215,3.741),but mean arterial pressure and D-dimer are not AECOPD combined independent risk factors for DVT(P>0.05).There was no significant difference in C-reactive protein,interleukin-6,interleukin-8,tumor necrosis factor,and arterial partial oxygen pressure between the two groups(P>0.05).Conclusion For AECOPD patients,the possibility of deep venous thrombosis can be inferred from the lower limb edema,pulmonary hypertension,and then the diagnosis and prevention of lower limb deep vein thrombosis can be achieved through targeted examination and treatment.

关 键 词：慢性阻塞性肺疾病急性加重 下肢深静脉血栓 临床特征 危险因素 

分 类 号：R447[医药卫生—诊断学] R563.3[医药卫生—临床医学]