COPD急性加重期并发静脉血栓栓塞症的发病情况及危险因素分析

Incidence and risk factors of acute exacerbation chronic obstructive pulmonary disease complicated with venous thromboembolism

目的探讨COPD急性加重期(AECOPD)并发静脉血栓栓塞症(的发病情况及危险因素。方法 VTE)回顾性分析306例AECOPD患者资料,查阅统计VTE的发病情况,根据是否发生VTE将患者分为VTE组和对照组,采用多因素Logistic回归分析其独立危险因素。结果 VTE的发生率为12.42%(38/306),其中仅深静脉血栓形成(DVT)发生率为7.52%(23/306),仅肺血栓栓塞症(PTE)发生率为2.61%(8/306),DVT合并PTE的发生率为2.29%(7/306)。多因素Logistic回归分析显示卧床≥3 d、血D-二聚体≥500μg/L、巴氏指数评分<60分、Charlson合并症指数>2(OR分别为2.874、2.345、3.770、2.893,P<0.05)与VTEVTE关系密切。结论以DVT最为常见,而且常发生在左下肢。卧床≥3d、血D-二聚体≥500μg/L、巴氏评分<60分和Charlson合并症指数>2是AECOPD并发VTE的独立危险因素。

Objective To investigate the incidence and risk factors of acute exacerbation chronic obstructive pulmonary disease(AECOPD)complicated with venous thromboembolism(VTE).Methods Clinical data of 306 patients with AECOPD were retrospectively analyzed,and their incidence of VTE was accessed and counted.The patients were divided into VTE Group and Control Group according to whether there was VTE.Multiple logistic regression analysis was used to analyze the independent risk factors.Results The incidence of VTE was 12.42%(38/306),of which the incidence of only deep vein thrombosis(DVT)was 7.52%(23/306),that of only pulmonary thromboembolism(PTE)was 2.61%(8/306),and that of DVT with PTE was 2.29%(7/306).Multiple logistic regression analysis showed that stay in bed≥3 days(OR=2.874),D-dimer≥500μg/L(OR=2.345),Barthel Index<60 points(OR=3.770),and Charlson comorbidity index>2(OR=2.893)were closely related to VTE.Conclusion VTE is the most common DVT,and often occurs in the left lower extremities.Stay in bed≥3 days,D-dimer≥500μg/L,Barthel Index<60 points and Charlson comorbidity index>2 were independent risk factors for AECOPD complicated with VTE.