慢性阻塞性肺疾病急性加重合并肺栓塞相关危险因素分析

目的 研究AECOPD合并肺栓塞（PE）的危险因素.方法 200例无明显原因的AECOPD患者,入院后行螺旋CT肺动脉造影（CTPA）检查,根据CTPA结果将患者分为合并肺栓塞和不合并肺栓塞两组,分别检测患者动脉血气、D-二聚体（D-dimer）、内皮素-1（ET-1）的含量.结果 两组间卧床≥7天,下肢不等粗≥1 cm,有无深静脉血栓形成,心电图示SIQⅢTⅢ征,PaCO2下降≥5的患者数目及患者的D-dimer和ET-1的含量有明显差异,经统计学分析,差异有统计学意义（P〈0.05）.结论 卧床≥7天,下肢不等粗≥1 cm,心电图示SIQⅢTⅢ,PaCO2下降≥5,深静脉血栓形成及D-dimer与ET-1含量的升高是AECOPD合并PE的相关危险因素.

Analysis of risk factors of AECOPD patients complicated with pulmonary embolism

Objective To investigate the risk factors of AECOPD patients complicated with pulmonary embolism （PE）. Methods 200 AECOPD patients with unclear reasons were randomly divided into the PE positive and the PE negative groups. The related indexes were determined after admission. Results There were 65 patients complicated with PE out of 200 AECOPD patients. The risk factors in- cluded stay in bed equal with or longer than 7 days, difference of lower limbs larger than 1 cm in thickness, deep venous thrombosis, SIQI- IITIII syndrome, PaCO2 , D-dimer and ET-I （P 〈 0. 05 ）. There was a positive correlation between D-dimer and ET-1 Conclusion The above mentioned indexes are the risk factors of AECOPD patients complicated with PE.