慢性阻塞性肺疾病肺动脉高压患者合并肺栓塞临床分析

Clinical Analysis of Pulmonary Embolism in COPD Patients with Hypertension

目的探讨慢性阻塞性肺疾病(COPD)患者肺动脉变化及临床表现特点与肺栓塞(PTE)的关系,提高COPD患者合并PTE的诊断。方法比较43例COPD合并栓塞组患者和41例非栓塞组患者的肺动脉压力变化以及临床特点。结果栓塞组与非栓塞组患者肺动脉压力升高情况比较差异有统计学意义(P<0.05);栓塞组下肢非对称性肿胀发生率、血浆D-二聚体阳性情况高于非栓塞组,差异均有统计学意义(P<0.05)。结论肺动脉压力变化、下肢非对称性肿胀及血浆D-二聚体水平是诊断COPD合并PTE的重要线索,发现这些情况应及时作CT肺动脉造影等相关检查。

Objective To probe into the changes of pulmonary artery pressure and clinical features in patients with chronic obstructive pulmonary disease （COPD） and the relationship with pulmonary thromboendalism （PTE） so as to improve the diagnosis of COPD patients with PTE. Methods The changes of pulmonary artery pressure and clinical features were compared between COPD patients with PTE （ n = 43） and with no PTE （ n = 41 ） . Results There was statistical difference in change of pulmonary artery pressure between the two groups （ P 〈 0.05 ）. The preverlence of asymmetric swelling of lower limbs and the level of plasma D - dimer were higher in patients with VIE than those with no PTE （ P 〈 0.05 ） . Conclusion The change of pulmonary artery presoure, asymmetric swelling of lower limbs and plasma D - dimer are the clues to diagnosis of PTE. Computed tomography pulmonary angiography and related examinations should be performed when the patient has the clinical findings mentioned above.