CAJ | 학술논문

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)合并深静脉血栓形成(DVT)患者的相关危险因素及抗凝因子变化.方法 110例AECOPD患者按下肢深静脉超声结果分为DVT组和非DVT组,对比分析其危险因素及抗凝指标.结果 110例AECOPD患者中,确诊DVT 12例(10.9%),合并肺血栓栓塞症2例(1.8%).与非DVT组比较,DVT组卧床>3 d、吸烟、机械通气的例数增多及住院时间延长(P<0.01),动脉血二氧化碳分压(PaCO2)增高(P<0.05);抗凝血酶Ⅲ活性、蛋白S含量下降(P<0.05)及血D-二聚体含量增加(P<0.05).结论造成AECOPD患者制动的因素如长期卧床及吸烟、机械通气是发生DVT的高危因素;且Ⅱ型呼吸衰竭的患者更容易合并DVT;AECOPD合并DVT患者存在纤溶功能失衡状态,应监测纤溶指标变化.
목적 분석만성조새성폐질병급성가중기(AECOPD)합병심정맥혈전형성(DVT)환자적상관위험인소급항응인자변화.방법 110례AECOPD환자안하지심정맥초성결과분위DVT조화비DVT조,대비분석기위험인소급항응지표.결과 110례AECOPD환자중,학진DVT 12례(10.9%),합병폐혈전전새증2례(1.8%).여비DVT조비교,DVT조와상>3 d、흡연、궤계통기적례수증다급주원시간연장(P<0.01),동맥혈이양화탄분압(PaCO2)증고(P<0.05);항응혈매Ⅲ활성、단백S함량하강(P<0.05)급혈D-이취체함량증가(P<0.05).결론 조성AECOPD환자제동적인소여장기와상급흡연、궤계통기시발생DVT적고위인소;차Ⅱ형호흡쇠갈적환자경용역합병DVT;AECOPD합병DVT환자존재섬용공능실형상태,응감측섬용지표변화.
Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P < 0.01 or <0.05 ). In DVT group, the activity of antithrombin Ⅲ and the level of protein S decreased (P < 0.05 ), and the level of D-Dimer increased (P < 0.05). Conclusions Long-term bed, smoke and mechanical ventilation requirement are the main risk factors of DVT in patients with AECOPD. Respiratory failure (type Ⅱ ) is easier to combine with DVT. Abnormality of coagulation and fibrinolytic system exists in AECOPD with DVT.