慢性阻塞性肺疾病急性加重期合并下肢深静脉血栓形成的影响因素

Influencing factors of acute exacerbation of chronic obstructive pulmonary disease complicated with deep venous thrombosis of lower extremities

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并下肢深静脉血栓形成(DVT)的影响因素。方法收集2018年1月至2020年12月首都医科大学附属北京朝阳医院收治的197例AECOPD患者的临床资料。根据下肢DVT发生情况分为DVT组(n=35)和非DVT组(n=162),AECOPD合并DVT影响因素的多因素分析采用Logistic回归分析。结果DVT组患者年龄、存在静脉血栓栓塞史、存在肺动脉高压史、卧床时间≥5 d、下肢非对称性肿胀≥1 cm、D-二聚体及C反应蛋白水平高于非DVT组患者(P<0.05);多因素回归分析显示,年龄>65岁、存在静脉血栓栓塞史、卧床时间≥5 d、下肢非对称性肿胀≥1 cm和D-二聚体水平升高是AECOPD合并DVT的独立危险因素(P<0.05)。结论AECOPD合并危险因素的患者易发生下肢DVT,需根据危险因素进行针对性预防,避免DVT的发生。

Objective To explore the influencing factors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with deep venous thrombosis(DVT).Method Clinical data of 197 case AECOPD patients admitted in Beijing Chao-yang Hospital,Capital Medical University from January 2018 to December 2020 was collected.The patients were divided into the thrombosis group(n=35)and non-thrombosis group(n=162)based on the occurrence of DVT of lower limbs.The multivariate analysis of AECOPD complicated with DVT was performed by logistic regression.Result The age,history of venous thromboembolism,pulmonary hypertension,time of staying in bed≥5 days,asymmetric swelling of lower extremities≥1 cm,levels of D-dimer and C-reactive protein(CRP)in the DVT group were higher than those in the non-DVT group(P<0.05).Multivariate logistic regression showed that age>65,history of venous thromboembolism,time of staying bed≥5 days,asymmetric swelling of lower extremities≥1 cm,and elevated D-dimer level were independent risk factors for AECOPD complicated with DVT(P<0.05).Conclusion AECOPD patients with risk factors tend to have DVT of lower extremities,which should be preventd based on risk factors.