| Objevtive:By comparing the basic conditions,concurrent diseases,risk factors and clinical characteristics of patients with chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary embolism(PE)and patients with AECOPD alone,we hope to carry out early identification and intervention for patients with AECOPD complicated with PE,and improve the prognosis.Methods:Selected in 2014-12~2019-12 month from hospitalization diagnosis of 26 patients with AECOPD combined PE as the cases,26 patients were performed pulmonary artery angiography(CT pulmonary angiography,CTPA)check the diagnosis of pulmonary embolism,at the same time with COPD basic diseases and has exclusive respiratory tract infection,and a diagnosis of AECOPD,choose 76 cases with acute aggravating ManJian obstructive pulmonary disease patients as control group(AECOPD).The general conditions of the two groups of patients were retrospectively analyzed: gender,age,smoking history,diabetes,hypertension,whether combined with atrial fibrillation or varicose veins of lower limbs,etc.Clinical features: fever,cough,expectoration,chest pain,hemoptysis,dyspnea,syncope,unilateral lower limb swelling and other symptoms and signs;Auxiliary examination: hemoglobin(Hb),white blood cell(WBC),white blood cell/lymphocyte ratio(N/L),blood partial pressure of carbon dioxide(PaCO2),PaO2,plasma fibrinogen,D 1/2 polymer,blood lipid,BNP.Ecg findings;Color doppler ultrasound of heart and deep veins of lower limbs;Chest CT imaging;The results were analyzed by SPSSl6.0 software.Result:1.General information: In terms of gender,smoking history,hypertension,diabetes,and history of atrial fibrillation,there was no significant difference between the two groups(P>0.05),but the difference was significant when age was a variable(P< 0.05).2.Risk factors: in terms of previous varicose vein history,the case group(COPD combined with PE group)was higher than the control group(COPD group),with a significant difference(P< 0.05).3.Clinical symptoms and signs: there was no statistical difference between the two groups in the aspects of fever,cough,expectoration,respiratory effort and hemoptysis(P>0.05),but there was a significant difference between the two groups in the manifestations of chest pain and syncope(P< 0.05).4.Blood test: The alveolar arterial oxygen partial pressure(PaO2)and blood carbon dioxide partial pressure(PaCO2)in the case group were significantly lower than those in the control group(P< 0.05).The control group was higher,blood lipids and BNP were also higher than the control group,both the difference was statistically significant(P< 0.05);.In terms of hemoglobin(Hb),WBC,WBC/lymphocyte ratio(N/L),fibrinogen and cholesterol,there was no significant statistical significance between the two groups(P >0.05).5.Electrocardiogram: sinus tachycardia in the case group was significantly higher than that in the control group(P< 0.05).6.Deep vein and cardiac ultrasound: the incidence of deep vein thrombosis in the case group was higher than that in the control group,and the difference was statistically significant(P< 0.05).The case group had a higher pulmonary artery pressure and a larger proportion of right heart enlargement than that in the control group.7.Imaging features: pleural effusion was more common in the case group than in the control group,with a significant difference(P< 0.05)..In conclusion:1.Patients with AECOPD and PE are older than those with simple AECOPD,and they are more likely to have varicose veins in the lower extremities.2.Patients with AECOPD and PE are more likely to have chest pain and syncope than patients with simple AECOPD.3.Patients with AECOPD and PE have lower PaO2 and PaCO2 than those with simple AECOPD,while blood lipids,D-dimer,BNP,and pulmonary artery pressure increase.4.Patients with AECOPD and PE have more pleural effusions,sinus tachycardia,and right heart enlargement than patients with AECOPD alone.5.D-dimer has higher diagnostic efficacy in patients with AECOPD and PE. |
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