A Retrospective Analysis Of The Clinical Features Of Chronic Obstructive Pulmonary Disease With Pulmonary Thromboembolism

[Objective]Through retrospective comparative analysis of clinical data of patients with chronic obstructive pulmonary disease(COPD)and pulmonary thromboembolism(PTE)with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients and pulmonary thromboembolism patients,to summarize the clinical characteristics of patients with COPD combined PTE.[Method]To gather information of patients diagnosed as COPD combined PTE,from January 1,2015 to December 31,2016 in Department of Respiratory Medicine,the First Affiliated Hospital of Kunming Medical University,and compared with AECOPD and PTE patients in hospital at the same period of time.In patients with COPD combined PTE compared with AECOPD patients for the following items:average age,sex,blood gas analysis(PCO2,PO2)admission,lung function grading distribution,hemoglobin,blood coagulation/fibrinolytic function(PT,APTT,Fib,D-D)and complications.In patients with COPD combined PTE compared with PTE patients for the following items:average age,sex,blood gas analysis(PCO2,PO2)admission,hemoglobin,blood coagulation/fibrinolytic function(PT,APTT,Fib,D-D),DVT and risk factors for DVT,INR "standard time".Use SSPS22.0 system for data analysis.[Results]This study included in 37 patients with COPD combined PTE,28 cases(75.7%)of men and women in 9 cases(24.3%),with an average age of 68.19 ± 7.71 years old.40 patients with AECOPD(Selected from 1244 cases from the same period randomly),male,31 cases(77.5%),9 cases of female patients(22.5%),with an average age of 66.40 ±8.15 years old.78 patients with PTE were male 35 cases(44.9%),female 43 cases(55.1%),with an average age of 54.03 ± 11.3 years old.Compared with hospitalized patients with AECOPD:The age,gender,and lung function in patients with no statistically significant difference;Symptoms of chest pain,syncope in COPD combined PTE group higher percentage;Hospital in arterial blood gas analysis,CO2 retention degree is similar in both groups,but the degree of hypoxia(SP02 extent)heavier COPD combined PTE group(P<0.05);Higher than that of AECOPD patients with COPD combined PTE hemoglobin group(P<0.05);Abnormal blood coagulation function/fiber dissolving,part activated clotting enzyme live time(APTT),fibrinogen(Fib),D-dimer above AECOPD group(P<0.05);Two groups of diabetes,hypertension,hyperlipidemia,lower limb varicosity complications such as blood ratio has no obvious difference.Compared with hospitalized patients with PTE,with an average age of patients with AECOPD combined PTE group was obviously higher;Women with higher percentage of patients with PTE group,and COPD combined PTE higher percentage of male;COPD combined PTE group of patients with chest pain,hemoptysis,difficulty breathing,the incidence of syncope were higher than in PTE group;Merger PTE group with COPD compared with arterial blood gas admission PTE group,the former co2 partial pressure(PCO2)is higher,lower oxygen partial pressure(PO2);COPD combined PTE hemoglobin is PTE group is higher,the gap was statistically significant(P<0.05);Thrombin time shorter PTE group(P<0.05);PT,APTT,D dimer in there was no statistically significant difference between the two groups.Two groups of patients with DVT diagnosis of COPD combined ratio is higher in PTE group,gap there is statistical significance(P<0.05).Risk factors for DVT in statistically difference between the two groups are:higher hemoglobin,hypertension,diabetes mellitus(both for COPD combined ratio is higher in PTE group,P<0.05),surgery and has a higher percentage in patients with PTE operation.Two groups of patients with the same anticoagulant principle,adjustment scheme and test index of the same circumstances,INR "standard" time has no obvious difference.[Conclusion]Patients with COPD combined PTE has the following characteristics:age;Men with high proportion;Chest pain,hemoptysis,difficulty breathing,syncope symptoms occur high proportion;Oxygen and carbon dioxide retention heavier;Higher hemoglobin in the etiology of is higher;D-dimer increased obviously;Rate of DVT and high risk factors of DVT are both higher.