抗凝治疗慢性阻塞性肺疾病急性加重疑诊肺栓塞的临床观察

Clinical observation of anticoagulation for acute exacerbation of chronic obstructive pulmonary disease with co-existing suspected acute pulmonary embolism

目的探讨慢性阻塞性肺疾病急性加重(AECOPD)疑诊肺栓塞(PE)进行抗凝治疗的有效性。方法将D-二聚体阳性的42例重度AECOPD患者分为血氧分压正常组(A组)和低氧血症组(B组),并进一步随机分为抗凝(A1、B1)和非抗凝(A2、B2)2个亚组。观察A组和B组抗凝和非抗凝治疗前后的变化。结果B1组与B2组比较,临床症状、动脉血气分析、D-二聚体水平等比较差异有统计学意义(P<0.05),B1组优于B2组。结论具有PE高危因素,D-二聚体阳性的重度AECOPD患者,应常规予以抗凝治疗。

Objective To investigate the efficacy of the anticoagulation for acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with co-existing suspected acute pulmonary embolism（PE）. Methods Forty-two inpatients with severe AECOPD with a positive D-dimer assay were divided into group A（a value of PaO2 was normal） and group B（hypoxia）.The two groups were randomly redistributed into anticoagulation subgroups（A1 and B1） and non-anticoagulation subgroups（A2 and B2）.The consequences of the management were surveyed and assessed. Results Compared with B2 subgroup,there were significant differences in dyspnea,PaO2,D-dimer（P〈0.05） in B1 subgroup. Conclusions Anticoagulation should immedidately be given to patients with severe AECOPD who have risk factors for venous thromboembolism or high probability for PE.