老年慢性阻塞性肺疾病患者急性加重期发生静脉血栓栓塞的危险因素

Risk factors for venous thromboembolism in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

目的探索老年慢性阻塞性肺疾病(COPD)患者急性加重期发生静脉血栓栓塞(VTE)的危险因素。方法收集2022年1—12月于海安市人民医院住院治疗的210例老年慢性阻塞性肺疾病急性加重(AECOPD)患者的临床资料,根据急性期是否发生VTE将患者分为VTE组(n=45)和对照组(n=165)。比较两组患者的临床特征、专科情况和住院期间主要治疗情况,分析老年COPD患者急性加重期发生VTE的危险因素。结果VTE组患者的年龄、骨性关节炎的比例、下肢水肿的比例、合并肺动脉高压的比例和使用有创呼吸机的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥80岁、合并肺动脉高压、使用有创呼吸机、合并骨性关节炎、合并下肢水肿均是老年COPD患者急性加重期发生VTE的独立危险因素(P﹤0.05)。结论年龄≥80岁、合并肺动脉高压、使用有创呼吸机、合并骨性关节炎、合并下肢水肿均会增加老年COPD患者急性加重期发生VTE的风险,在临床中应予以关注。

Objective To investigate the risk factors for venous thromboembolism(VTE)in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Method The clinical data of 210 elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)who were hospitalized in Hai'an People's Hospital from January to December 2022 were collected.Patients were divided into VTE group(n=45)and control group(n=165)according to whether VTE occurred in the acute phase.The clinical characteristics,specialties,and main treatments during hospitalization were compared between the two groups of patients,the risk factors for VTE in elderly COPD patients during acute exacerbation were also analyzed.Result The age,proportion of osteoarthritis,proportion of lower limb edema,proportion of patients with pulmonary hypertension,and proportion of patients using invasive ventilators in the VTE group were all higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that age≥80 years old,combined with pulmonary hypertension,use of invasive ventilator,combined with osteoarthritis,and combined with lower limb edema were all independent risk factors for VTE in elderly COPD patients during acute exacerbation(P<0.05).Conclusion Age≥80 years old,combined with pulmonary hypertension,use of invasive ventilator,combined with osteoarthritis,and combined with lower limb edema would increase the risk of VTE in elderly COPD patients during acute exacerbation,which should be paid attention to in clinical practice.