CAJ | 학술논문

目的分析COPD合并慢性肺栓塞患者的临床特征,加强对COPD患者中原位肺栓塞形成的认识,评价抗凝治疗在COPD中的应用价值,为基层医院提供COPD合并慢性肺栓塞的临床经验性诊断和治疗的依据.方法入选COPD合并肺栓塞患者53例,设为研究组,选取同期AECOPD患者70例设为对照组.对照分析两组患者的临床特征.观察研究组患者抗凝治疗的疗效.结果两组患者比较,血浆D-二聚体、双下肢静脉彩超差异无统计学意义(P＞0.05);血红蛋白水平、6分钟步行试验、CAT评分、mMRC评分、PaCO2、PaO2、A-aDO2、FEV1％pred、肺动脉压均有明显差异,差异有统计学意义(P＜0.05).研究组患者经抗凝治疗后,上述指标有明显改善,血红蛋白及肺动脉压降低,但差异无统计学意义(P＞0.05),余指标治疗后改善,与治疗前比较差异均具有统计学意义(P ＜0.05).结论慢性肺栓塞是导致COPD患者出现顽固性低氧血症、活动能力差的重要因素,抗凝治疗对COPD合并慢性肺栓塞患者具有可靠的临床应用价值.
목적 분석COPD합병만성폐전새환자적림상특정,가강대COPD환자중원위폐전새형성적인식,평개항응치료재COPD중적응용개치,위기층의원제공COPD합병만성폐전새적림상경험성진단화치료적의거.방법 입선COPD합병폐전새환자53례,설위연구조,선취동기AECOPD환자70례설위대조조.대조분석량조환자적림상특정.관찰연구조환자항응치료적료효.결과 량조환자비교,혈장D-이취체、쌍하지정맥채초차이무통계학의의(P＞0.05);혈홍단백수평、6분종보행시험、CAT평분、mMRC평분、PaCO2、PaO2、A-aDO2、FEV1％pred、폐동맥압균유명현차이,차이유통계학의의(P＜0.05).연구조환자경항응치료후,상술지표유명현개선,혈홍단백급폐동맥압강저,단차이무통계학의의(P＞0.05),여지표치료후개선,여치료전비교차이균구유통계학의의(P ＜0.05).결론 만성폐전새시도치COPD환자출현완고성저양혈증、활동능력차적중요인소,항응치료대COPD합병만성폐전새환자구유가고적림상응용개치.
Objective Analysis the clinical features of chronic obstructive pulmonary disease (COPD) with chronic pulmonary embolism,to strengthen the understanding of the in situ pulmonary embolism in patients with COPD,to provide the clinical experience of diagnosis and treatment of COPD combined with chronic pulmonary embolism for basic-level hospitals.Methods We selected 53 COPD complicated with PE patients defined as research group,while selected 70 COPD patients in the same period defined as control group,compare the differences of clinical characteristics between the two groups.Observe the curative effect of the case group after anticoagulant therapy.Results There were no difference in D-dimmer and double lower limbs vein ultrasound between the two groups,but Hemoglobin levels,6 minutes walk test,CAT scores,mMRC score,PaCO2,PaO2,A-aDO2,FEV1 ％ pred,pulmonary artery systolic pressure have obvious differences (P ＜0.05).After anticoagulation,the above indexes were obviously improved.Conclusions Chronic pulmonary embolism is an important factor which causes stubborn hypoxemia and poor activity of COPD.Anticoagulant therapy has reliable clinical value for COPD combine with chronic pulmonary embolism.