慢性阻塞性肺疾病急性加重期患者合并肺栓塞的危险因素分析

Risk factors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者合并肺栓塞的相关危险因素。方法选择50例AECOPD合并肺栓塞患者为病例组,100例AECOPD无肺栓塞患者为对照组。分析两组患者的临床资料;单因素及多因素Logistic回归分析AECOPD患者并发肺栓塞的相关危险因素。结果病例组患者动脉血氧分压、部分活化凝血酶原时间低于对照组,动脉血二氧化碳分压、肺泡-动脉血氧分压差(P_(A-a)O_(2))、D-二聚体(D-D)、纤维蛋白原(FIB)、红细胞压积高于对照组(P<0.05)。Logistic回归分析显示,D-D、P_(A-a)O_(2)、FIB水平升高为AECOPD合并肺栓塞的危险因素。ROC曲线分析显示,D-D预测AECOPD并发肺栓塞的灵敏度和特异度最高。结论D-D、P_(A-a)O_(2)、FIB升高为AECOPD患者并发肺栓塞的危险因素。

Aim To investigate the risk factors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 50 patients with AECOPD complicated with pulmonary embolism were treated as the case group,and 100 patients without pulmonary embolism in AECOPD were treated as the control group.The clinical data of the two groups were analyzed;Univariate and multivariate Logistic regression analysis was used to analyze the related risk factors of pulmonary embolism in AECOPD patients.Results The arterial partial pressure of oxygen and partial activated prothrombin time of patients in the case group were lower than those in the control group,while the arterial partial pressure of carbon dioxide,alveolar arterial partial pressure difference of oxygen(P_(A-a)O_(2)),D-dimer(D-D),fibrinogen(FIB),and hematocrit of patients in the case group were higher than those in the control group(P<0.05).Logistic regression analysis showed that elevated levels of D-D,P_(A-a)O_(2)and FIB were risk factors for AECOPD with pulmonary embolism.ROC curve analysis showed that D-D has the highest sensitivity and specificity in predicting AECOPD complicated with pulmonary embolism.Conclusion Significant rise of D-D,alveolar arterial partial pressure of oxygen,and fibrinogen are the related risk factors for pulmonary embolism in AECOPD patients.