老年慢性阻塞性肺疾病急性加重病人发生静脉血栓栓塞症的临床特征和危险因素分析  

Clinical features and risk factors of venous thromboembolism in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：李佳 陈小兰 潘磊 LI Jia;CHEN Xiao-lan;PAN Lei(Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Beijing 100038, China)

机构地区：[1]首都医科大学附属北京世纪坛医院呼吸与危重症医学科,北京市100038

出　　处：《实用老年医学》2022年第4期374-377,共4页Practical Geriatrics

基　　金：北京市科技计划课题(Z181100001718160)。

摘　　要：目的探讨老年慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)病人发生静脉血栓栓塞症(venous thromboembolism,VTE)的临床特征和危险因素。方法纳入2016年1月至2019年12月在我院确诊的老年AECOPD病人208例为研究对象,根据是否发生VTE分为AECOPD+VTE组(49例)和AECOPD组(159例),收集临床资料、实验室检查指标,比较2组临床特征,并分析发生VTE的危险因素。结果AECOPD+VTE组肌间静脉的栓塞发生率最高,在年龄<80岁和≥80岁的病人中分别为64.0%和91.7%。2组年龄、静脉血栓病史、近3 d制动或卧床史、不对称下肢水肿、合并冠心病、肺功能GOLD严重程度分级、血清白蛋白和D-二聚体水平差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,深静脉血栓病史、合并冠心病、D-二聚体升高是老年AECOPD病人发生VTE的独立危险因素。结论老年AECOPD病人发生VTE时,下肢肌间静脉血栓的发生率高;深静脉血栓病史、合并冠心病、D-二聚体升高是老年AECOPD病人发生VTE的独立危险因素。Objective To investigate the clinical features and risk factors of venous thromboembolism(VTE)in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From January 2016 to December 2019,208 confirmed elderly patients with AECOPD in our hospital were enrolled.According to the occurence of VTE,the patients were divided into AECOPD+VTE group(49 cases)or AECOPD group(159 cases).The clinical and laboratory data were collected and compared between 2 groups,and the risk factors of VTE were analyzed.Results Intermuscular venous thrombosis occurred most in the AECOPD+VTE group,reaching 64.0%in the patients aged under 80 years old and 91.7%in the patients aged over 80 years old.There were significant differences in age,history of VTE,immobilization time>3 d,asymmetrical edema,coronary heart disease(CHD),GOLD classification,serum levels of albumin and D-dimer between the two groups(P<0.05).Multivariate Logistic regression analysis showed that the history of VTE,CHD and higher level of D-dimer were independent risk factors of VTE in the elderly AECOPD patients.Conclusions The morbidity of lower-limb intermuscular venous thrombosis is high,and the history of VTE,CHD and higher level of D-dimer are independent risk factors of VTE in the the elderly AECOPD patients.

关 键 词：老年人 慢性阻塞性肺疾病急性加重 静脉血栓栓塞症 临床特征 危险因素 

分 类 号：R563[医药卫生—呼吸系统] R543.6[医药卫生—内科学]