凝血酶生成指数和Wells评分可预测慢性阻塞性肺疾病急性加重期患者的肺栓塞

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2025-01-01 DOI:10.1016/j.clinsp.2025.100582

Linjie Luo , Dan Zheng , Li Da, Jian Cheng, Yirui Cao, Na Wang

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引用次数: 0

摘要

目的探讨凝血酶生成指数和Wells评分对慢性阻塞性肺疾病急性加重期（AECOPD）患者肺栓塞（PE）发生的预测价值。方法收集我院收治的AECOPD行CT肺动脉造影（CTPA）的患者160例。其中诊断为PE的共62例为有PE组，未诊断为PE的共98例为AECOPD组。比较两组患者的一般资料、既往病史及合并基础疾病、实验室检查等相关临床资料，并对收集到的资料进行统计分析，探讨预测AECOPD患者PE的诊断指标。结果AECOPD合并PE组静脉血栓栓塞史、d-二聚体、内源性凝血酶电位（ETP）、活化部分凝血酶时间（APTT）凝血指标、Wells评分均显著高于AECOPD组，峰值时间（ttpeak）、白蛋白（ALB）、总蛋白均显著低于AECOPD组。Wells评分与ETP、APTT呈正相关，与ttpeak呈负相关，均为AECOPD中PE的独立危险因素。Wells评分预测AECOPD患者PE发生的效果最好，临界值为4.62。结论凝血酶生成指数（ETP、APTT、ttpeak）与Wells评分有显著相关性，也可用于AECOPD患者PE的早期诊断。

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Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective

This study investigated the predictive value of thrombin generation indices and Wells score in the development of Pulmonary Embolism (PE) in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).

Methods

160 patients who were admitted for AECOPD and underwent CT Pulmonary Arteriography (CTPA) were collected. Among them, a total of 62 cases were diagnosed with PE as the AECOPD with PE group, and the other 98 cases were not diagnosed with PE as the AECOPD group. The general data, past history and combined basic diseases, laboratory tests and other related clinical data of the two groups were compared, and the data collected were statistically analyzed to explore the diagnostic indexes that can predict PE in AECOPD.

Results

History of venous thromboembolism, d-Dimer as well as Endogenous Thrombin Potential (ETP), Activated Partial Thromboplastin Time (APTT) coagulation indices, and Wells score was significantly higher in the AECOPD with PE group than in the AECOPD group, and Time to Peak (ttpeak), Albumin (ALB) and total protein were lower than those in the AECOPD group. The Wells score had a positive correlation with ETP and APTT and a negative correlation with ttpeak, which were all independent risk factors for PE in AECOPD. The Wells score had the best efficacy in predicting the occurrence of PE in patients with AECOPD with a cutoff value of 4.62.

Conclusion

Significant correlations were found between the thrombin generation indices (ETP, APTT and ttpeak) and the Wells score, which can also be used for early diagnosis of PE in patients with AECOPD.

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.