RICU慢性阻塞性肺疾病患者下肢深静脉血栓形成的流行病学分析
Status of COPD patients with deep venous thrombosis in RICU

摘要：目的 探讨呼吸重症监护病房(respiratory intensive care unit, RICU)慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者下肢深静脉血栓形成(deep vein thrombosis, DVT)的发病率及相关危险因素。方法 连续收集我院RICU自2015年1月至2015年12月住院的COPD患者204例，收集患者的基本临床资料，住院24～48h内行床旁双下肢静脉超声检查。将患者分为DVT组及非DVT组，并对两组患者的临床资料进行分析比较，多因素Logistic回归分析相关危险因素。ROC曲线分析评价实验指标的疾病识别能力。结果 204例患者中有39例发生DVT，总体发病率为19.1%。DVT组患者的D二聚体较非DVT组明显升高(P<0.001)，而两组患者在年龄、性别、吸烟史、基础疾病、其他实验室检查等方面无统计学差异。D二聚体的ROC曲线下面积为0.787，具有统计学差异，其cut off值为1.985mg/L，灵敏度为0.641，特异度为0.817。结论 RICU中COPD患者D二聚体升高与DVT的发生密切相关。
ABSTRACT: Objective To analyze the incidence and related risk factors of chronic obstructive pulmonary disease (COPD) patients with deep venous thrombosis (DVT) in the respiratory intensive care unit (RICU). Methods We recruited 204 patients from RICU of our hospital between January 2015 and December 2015. The basic clinical data of the patients were also collected. Bedside venous ultrasonography of double lower limbs was taken 24-48 hours after admission. The patients were divided into DVT group and non-DVT group. The clinical data of the two groups were analyzed and compared using Chi-square test or t test, Logistic regression analysis was used to analyze risk factors, and ROC curve analysis was used to identify the disease. Results Among the 204 patients, 39 were identified with DVT, with the overall incidence rate of 19.1%. D-dimer in DVT group was significantly higher than that in non-DVT group (P<0.001). The two groups did not significantly differ in age, sex, smoking history, underlying diseases, or other laboratory test results. The area under the ROC curve of D-dimer was 0.787, and the cut off value was 1.985mg/L (sensitivity of 0.641, specificity of 0.817). Conclusion D-dimer is closely associated with increased incidence of DVT in COPD patients