|
|
Risk factors of pulmonary embolism in patients with AECOPD and
predictive value of Caprini thrombosis risk assessment scale |
CHEN Wei1, FAN Jing2, AI Jiao2, LIAO Jun-zhe3 |
(1. ICU, Third People′s Hospital of Chengdu, Chengdu Sichuan 610031; Department of Emergency,Chengdu Fifth People′s Hospital,Chengdu Sichuan 611130; Department of Respiratory Medicine, Chengdu Fifth People′s Hospital,Chengdu Sichuan 611130, China)
|
|
|
Abstract Objective: To analyze the risk factors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD), and to explore the predictive value of Caprini thrombosis risk assessment scale on AECOPD pulmonary embolism.Methods: A total of 218 patients with AECOPD and pulmonary embolism were selected as observation group, and a total of 126 patients with AECOPD but without pulmonary embolism at the same time period were selected as control group. Logistic regression analysis was used to investigate the risk factors for pulmonary embolism in hospitalized patients with AECOPD. The Caprini score was compared between the two groups, and the relationship between Caprini score and risk of AECOPD pulmonary embolism was explored.Results: The incidences of diabetes, malignant tumor, lower extremity trauma, surgery within 6 weeks, cerebrovascular accident, and prolonged bed rest were significantly higher in the observation group than those in the control group(P0.05). History of diabetes mellitus, history of malignant tumor, history of surgery within 6 weeks, history of lower extremity trauma, history of cerebrovascular accident and longterm bedridden were independent risk factors for pulmonary embolism(P<0.05). The Caprini score in observation group was significantly higher than that in control group(P<0.05). In observation group, 117 patients(53.67%) were at extremely high risk and 53 patients(24.31%) were at high risk, and the proportion of high risk and above accounted for 77.98%. In control group, 66 patients(52.37%) were at moderately high risk and 36 cases(28.57%) were at low risk. There was a statistically significant difference in the composition ratio of risk grades between the two groups(P<0.05). Caprini risk is classified as a highrisk and highrisk AECOPD patient at high risk for pulmonary embolism. With the increase of Caprini risk grades, the risk of pulmonary embolism was significantly increased(P<0.05). Conclusion: The risk factors for pulmonary embolism in patients with AECOPD are history of diabetes mellitus, history of malignant tumor, history of surgery within 6 weeks, history of lower extremity trauma, history of cerebrovascular accident and longterm bedridden. The Caprini thrombosis risk assessment scale can be used for AECOPD pulmonary embolism and prognosis assessment.
|
Received: 11 February 2019
|
|
|
|
[1]ToledoPons N,Cosío BG,Velasco MD,et al.Chronic obstructive pulmonary disease in nonsmokers\[J\]. Arch Bronconeumol, 2017, 53(2):45-46.[2]Yin T, Zhu Z, Mei Z, et al. Analysis of viral infection and biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease\[J\]. Clin Respir J,2018,12(3):1228-1239.[3]Pourmand A, Robinson H, Mazeramirshahi M, et al. Pulmonary embolism among patients with acute exacerbation of chronic obstructive pulmonary disease: implications for emergency medicine\[J\]. J Emerg Med, 2018, 55(3):339-346.[4]徐佩枫, 陈玉玲. 慢性阻塞性肺病急性加重伴肺栓塞的危险因素\[J\]. 临床肺科杂志, 2017, 22(8):24-28.[5]陈央,周海霞,胡月红,等. 老年和非老年肺栓塞的危险因素及Caprini血栓风险评估量表的预测价值\[J\]. 中华医学杂志, 2017, 97(10):755-760.[6]中华医学会心血管病学分会肺血管病学组,中国医师协会心血管内科医师分会.急性肺血栓栓塞症诊断治疗中国专家共识\[J\].中华内科杂志,2010,49(1):74-81.[7]熊长明, 郑亚国, 何建国,等. 2014版欧洲心脏病学会急性肺血栓栓塞症诊断治疗指南解读\[J\]. 中国循环杂志, 2014,29(11):864-866.[8]潘元美, 曹雯炜, 秦洁行, 等. 血栓形成的抗栓治疗和预防,第9版:美国胸科医师学院循证的临床实践指南\[J\]. 神经病学与神经康复学杂志, 2012, 9(1):43-64.[9]Ishimaru N, Ohnishi H, Yoshimura S, et al. The sensitivities and prognostic values of the Wells and revised Geneva scores in diagnosis of pulmonary embolism in the Japanese population\[J\]. Respir Investig,2018,56(5):399-404.[10]Jimenez D, Bikdeli B, Marshall PS, et al. Aggressive treatment of intermediaterisk patients with acute symptomatic pulmonary embolism\[J\]. Clin Chest Med,2018,39(3):569-581.[11]孙娜,陈义强,孙彬峰,等.低钠血症与中危急性肺栓塞患者血流动力学和预后的关系\[J\].中华心血管病杂志,2018,46(12):976-980.[12]Dado CD, Levinson AT, Bourjeily G. Pregnancy and pulmonary embolism\[J\]. Clin Chest Med,2018,39(3):525-537.[13]Zahid H, Hassan S, Gul S, et al. Coexisting bilateral pulmonary embolism and intracardiac mass: a case of catastrophic antiphospholipid syndromelike disease\[J\]. Cureus,2018,10(10):e3438.[14]Jin Q, Luo Q, Zhao Z, et al. Takotsubo syndrome with pulmonary embolism: a case report and literature review\[J\]. BMC Cardiovasc Disord,2018,18(1):229.[15]吕侯强,崔淑芬,谢轩.高血糖对慢性阻塞性肺疾病急性加重期患者炎性与血凝状态及肺功能影响的观察\[J\]. 中国糖尿病杂志, 2018, 26(8):47-51.[16]王翔, 张雨洁.恶性肿瘤患者凝血功能异常的研究进展\[J\]. 现代肿瘤医学,2016, 24(8): 1325-1328.[17]Tomaiuolo M, Brass LF, Stalker TJ. Regulation of platelet activation and coagulation and its role in vascular injury and arterial thrombosis\[J\]. Interv Cardiol Clin, 2017, 6(1):1-12.[18]Yu Y,Yang L, Zhang Y, et al. Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients with diagnosis of pulmonary embolism for the first time in real world\[J\]. Clin Respir J,2018,12(11):2551-2558.[19]李建刚, 毛则先. 普通肝素联合活血通络方对长期卧床老年下肢深静脉血栓的治疗价值\[J\]. 血栓与止血学, 2018, 24(1):54-56.[20]陈旭锋,吕金如,李琳,等.肺栓塞的危险因素、症状与危险分层的相关性分析\[J\].南京医科大学学报(自然科学版),2017,37(12):1633-1635. |
|
|
|