Risk Factors For Pulmonary Thromboembolism In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To explore the risk factors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with pulmonary thromboembolism(PTE),so as to find the early diagnosis and treatment in time,improve prognosis and reduce the risk of death.Methods: 112 patients with AECOPD who underwent CT pulmonary angiography(CTPA)from October of 2014 to May of 2017 in the first Hospital of Lanzhou University were collected.According to whether the patients were complicated with PTE,they were divided into two groups: 46 cases in the combined with PTE group(AECOPD combined with PTE group)and 66 cases in the Simple AECOPD group(Simple AECOPD group).The differences in basic data,clinical symptoms and signs,past history and personal history,laboratory data and examination data between the two groups were analyzed,and the results were analyzed by SPSS19.0 software.Results: 1.There were significant differences in bed rest time≥3 days,hemoptysis,syncope,lower extremity asymmetric swelling,the history of pulmonary heart disease and venous thromboembolism(VTE),erythrocyte count,PO2,D-dimer,SIQIIITIII sign on electrocardiogram,inversion of T wave in upper chest lead of electrocardiogram,deep venous thrombosis(DVT),pulmonary artery pressure between the two groups(P < 0.05).2.Multivariate Logistic analysis was performed on the factors with statistical significance in univariate analysis above.The results showed that bed rest time≥3 days,lower extremity asymmetrical swelling,D-dimer≥2.00ug/ml,SIQIIITIII sign on electrocardiogram,DVT were the risk factors of AECOPD combined with PTE.The risk degree of AECOPD combined with PTE was D-dimer≥2.00ug/ml,SIQIIITIII sign on electrocardiogram,DVT,bed rest time≥3 days and lower extremity asymmetrical swelling.Conclusions: There were many risk factors associated with PTE,including bed rest time ≥3 days,hemoptysis,syncope,lower extremities asymmetric swelling,history of pulmonary heart disease,VTE,erythrocyte count,PO2,D-dimer≥2.00ug/ml,SIQIIITIII sign on electrocardiogram,inversion of T wave in upper chest lead of electrocardiogram,DVT,pulmonary artery pressure were the influencing factor of AECOPD with PTE,especially when D-dimer≥2.00ug/ml,SIQIIITIII sign on electrocardiogram,DVT,bed-rest time≥3 days,lower extremity asymmetrical swelling,it is needful to eliminate PTE.