关键词: 慢性阻塞性肺疾病急性加重期, 肺血栓栓塞症, 下肢静脉血栓, 肺动脉高压, 纤维蛋白原

Abstract: Objective This study aims to explore the independent risk factors for pulmonary thromboembolism in acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to construct a mathematical model to evaluate predictive efficacy through in-depth analysis of these factors. Method 385 detailed medical records of AECOPD patients treated at Inner Mongolia Autonomous Region People's Hospital from January 2019 to March 2023 were selected for analysis. The research subjects were divided into a group without pulmonary thromboembolism and a group with pulmonary thromboembolism. Using univariate and multivariate analysis strategies to identify the determining factors of pulmonary thromboembolism in AECOPD. Result Among the 385 patients involved in the study, 53 were diagnosed with concomitant pulmonary thromboembolism. Univariate and multiple logistic regression analysis confirmed that Pap's index, length of bed rest, lower limb venous thrombosis, right heart dysfunction, arterial oxygen pressure, fibrinogen, and C-reactive protein were independent risk factors for AECOPD complicated with pulmonary thromboembolism (P<0.05). By using a logistic regression model that includes independent influencing factors and P-values, a ROC curve was constructed to predict the occurrence of pulmonary thromboembolism in AECOPD. The areas under the curve showed discriminative abilities of 0.707, 0.660, 0.575, 0.654, 0.719, 0.712, and 0.669, respectively. The P-value prediction was particularly outstanding, reaching 0.905. Conclusion Pulmonary thromboembolism in AECOPD patients is closely related to factors such as Pap's index. The established prediction model exhibits significant predictive ability in terms of specificity and sensitivity.

Key words: acute exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, lower extremity venous thrombosis, pulmonary hypertension, fibrinogen