Caprini风险评估模型在慢性阻塞性肺疾病中的应用分析(1)
摘要：目的 探讨Caprini风险评估模型在慢性阻塞性肺疾病急性加重期(AECOPD) 患者静脉血栓栓塞(VTE) 预防中的应用探索。方法 583例AECOPD患者均按照Caprini风险评估模型进行VTE危险度评估，据Caprini风险评估模型将病人分为低危组(≤1分)、中危组(2分)、高危组(3～4分)和极高危组(>4分)；对非低危组同意应用低分子肝素钠者进行预防性抗凝治疗。观察各组间VTE发生率、出血发生率。结果 非低危组拒绝应用低分子肝素抗凝病例267例，其VTE的发病率为7.87%(21/267)。抗凝治疗组VTE的整体发生率为0.95%(3/316)，其中2例为DVT，1例为非高危PTE；抗凝治疗病例中出血发生率为2.59%(8/309)。结论 临床上，利用Caprini风险评估模型对AECOPD患者进行VTE分层并给予预防性干预，能够评估及降低VTE发生率。但仍需进一步改进以更加符合中国人AECOPD患者VTE风险评估。
关键词：慢性阻塞性肺疾病；静脉血栓栓塞症；Caprini风险评估模型
, http://www.100md.com
中图分类号：R563.9 文献标识码：A 文章编号：1006-1959(2017)26-0044-03
Abstract：Objective To explore the application of Caprini risk assessment model in the prevention of venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 583 AECOPD patients were evaluated for VTE risk according to the Caprini risk assessment model.According to the Caprini risk assessment model，patients were divided into low risk group(≤1 points)， intermediate risk group(2 points)，high risk group(3 to 4 points)and very high-risk group (>4 points)；The low risk group agreed to the application of low molecular weight heparin for anticoagulation therapy.The incidence rate was observed between VTE and incidence of bleeding.Results A total of 267 cases of low molecular weight heparin anticoagulation were rejected in non-low-risk group.The incidence of VTE was 7.87%(21/267).The overall incidence of VTE in the anticoagulant group was 0.95%(3/316)，of which 2 were DVT and 1 was non-high-risk PTE.The incidence of bleeding in anticoagulation was 2.59%(8/309).Conclusion Clinically，the use of Caprini risk assessment model of AECOPD patients with VTE stratification and preventive intervention，to assess and reduce the incidence of VTE.However，further improvement is needed to better assess the VTE risk of AECOPD patients in China.
, 百拇医药
Key words：Chronic obstructive pulmonary disease；Venous thromboembolism；Caprini risk assessment model
静脉血栓栓塞栓塞症(Venous thromboembolism，VTE)是住院患者常见的并发症和重要死因之一，它包括深静脉血栓形成(Deep venous thrombosis，DVT)和肺血栓栓塞症(Pulmonary thromboembolism，PTE)。慢性阻塞性肺疾病急性加重期(Acute exacerbation chronic obstructive pulmonary disease，AECOPD)由于慢性缺氧及二氧化碳潴留等病理生理特征，其本身亦是VTE的危險因素。国内的研究表明，慢性阻塞性肺疾病急性加重期患者DVT的患病率为9.7%[1]，VTE的发生率为14.5%[2]。目前国内尚无针对AECOPD合并VTE风险评估模型的相关研究，多个研究表明Caprini风险评估工具能够有效的基于个体危险因素在内科住院患者中进行量化的VTE风险评估[3-4]。为了解Caprini风险评估模型(Caprini prediction score，CPS)是否适用于AECOPD患者VTE的风险评估，我们做了该调查研究，现报道如下。
1资料与方法
1.1一般资料
自2015年12月～2016年12月收入我院呼吸内科住院的患者，共983例，最终纳入病例583例，其中男性340例，女性243例，平均年龄(66.72±4.12)岁，平均体重(56.12±4.32)kg。该研究所有程序均已通过四川省绵阳市中心医院伦理委员会审核，并取得了患者和/或家属的知情同意。, http://www.100md.com(吴君华 吴友茹 李丹)
关键词：慢性阻塞性肺疾病；静脉血栓栓塞症；Caprini风险评估模型
, http://www.100md.com
中图分类号：R563.9 文献标识码：A 文章编号：1006-1959(2017)26-0044-03
Abstract：Objective To explore the application of Caprini risk assessment model in the prevention of venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 583 AECOPD patients were evaluated for VTE risk according to the Caprini risk assessment model.According to the Caprini risk assessment model，patients were divided into low risk group(≤1 points)， intermediate risk group(2 points)，high risk group(3 to 4 points)and very high-risk group (>4 points)；The low risk group agreed to the application of low molecular weight heparin for anticoagulation therapy.The incidence rate was observed between VTE and incidence of bleeding.Results A total of 267 cases of low molecular weight heparin anticoagulation were rejected in non-low-risk group.The incidence of VTE was 7.87%(21/267).The overall incidence of VTE in the anticoagulant group was 0.95%(3/316)，of which 2 were DVT and 1 was non-high-risk PTE.The incidence of bleeding in anticoagulation was 2.59%(8/309).Conclusion Clinically，the use of Caprini risk assessment model of AECOPD patients with VTE stratification and preventive intervention，to assess and reduce the incidence of VTE.However，further improvement is needed to better assess the VTE risk of AECOPD patients in China.
, 百拇医药
Key words：Chronic obstructive pulmonary disease；Venous thromboembolism；Caprini risk assessment model
静脉血栓栓塞栓塞症(Venous thromboembolism，VTE)是住院患者常见的并发症和重要死因之一，它包括深静脉血栓形成(Deep venous thrombosis，DVT)和肺血栓栓塞症(Pulmonary thromboembolism，PTE)。慢性阻塞性肺疾病急性加重期(Acute exacerbation chronic obstructive pulmonary disease，AECOPD)由于慢性缺氧及二氧化碳潴留等病理生理特征，其本身亦是VTE的危險因素。国内的研究表明，慢性阻塞性肺疾病急性加重期患者DVT的患病率为9.7%[1]，VTE的发生率为14.5%[2]。目前国内尚无针对AECOPD合并VTE风险评估模型的相关研究，多个研究表明Caprini风险评估工具能够有效的基于个体危险因素在内科住院患者中进行量化的VTE风险评估[3-4]。为了解Caprini风险评估模型(Caprini prediction score，CPS)是否适用于AECOPD患者VTE的风险评估，我们做了该调查研究，现报道如下。
1资料与方法
1.1一般资料
自2015年12月～2016年12月收入我院呼吸内科住院的患者，共983例，最终纳入病例583例，其中男性340例，女性243例，平均年龄(66.72±4.12)岁，平均体重(56.12±4.32)kg。该研究所有程序均已通过四川省绵阳市中心医院伦理委员会审核，并取得了患者和/或家属的知情同意。, http://www.100md.com(吴君华 吴友茹 李丹)
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