COPD合并肺栓塞的危险因素及临床特征分析

目的探讨COPD合并肺栓塞(PE)患者的临床特征,并研究其发病的危险因素。方法入选COPD合并PE患者24例设为病例组(COPD+PE组),选取同期COPD急性加重患者54例设为对照组(单纯COPD组),比较两组患者在发生PE危险因素及临床特征之间的差异。结果两组患者在静脉血栓史、恶性肿瘤、6周内手术史、长期卧床(≥7 d)的危险因素比较中差异有统计学意义(P<0.05);晕厥、下肢非对称性肿胀、深静脉血栓形成、SⅠQⅢTⅢ征、PaCO2、血D-二聚体水平差异有统计学意义(P<0.05)。结论 COPD患者发生PE的危险因素为静脉血栓史、恶性肿瘤、6周内手术史、长期卧床(≥7 d)。当COPD患者出现晕厥、下肢非对称性肿胀、深静脉血栓形成、SⅠQⅢTⅢ综合征、PaCO2降低及血D-二聚体升高时,应警惕并发PE。

The analysis of risk factors and clinical characteristics of chronic obstructive pulmonary disease complicated with pulmonary embolism

Objective To investigate the risk factors and clinical characteristics of chronic obstructive pulmonary disease（COPD） complicated with pulmonary embolism （ PE ）. Methods We selected 24 COPD complicated with PE patients defined as case group （ COPD ＋ PE group）, while selected 54 acute exacerbation of COPD patients in the same period defined as control group （ pure COPD group） , compare the differences of risk factors and clinical characteristics between the two groups. Results There were significant differ- ences in previous venous thromboembolism, cancer, surgery within 6 weeks, immobilization time t〉7 days between the two groups; synco- pe, asymmetric swelling of lower limbs, deep venous thrombosis, S I Q H]T ]II syndrome in ECG also with significant difference （ P 〈 0. 05 ） ; The level of Carbon dioxide （ PaCO2 ） in blood serum was significantly reduced in COPI） patients with PE compared with the pa- tients with COPD, plasma D-dimer were significantly higher in patients with PE as compared Io patients without PE. Conclusion The risk factors of pulmonary embolism in COPD patients are previous venous thromboembolism, cancer, surgery within 6 weeks, immobiliza- tion time~〉7 days. The COPD patients who present with syncope, asymmetric swelling of lower limbs, S ] QmTlll syndrome in ECG, the level of Carbon dioxide （ PaCO2 ） reduced and the level of D-dimer elevated should be suspected of complicated with pulmonary embolism.