慢性阻塞性肺疾病急性加重合并肺栓塞的研究进展

Research Progress of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Pulmonary Embolism

摘要: 慢性阻塞性肺疾病(慢阻肺)的发病率和死亡率呈上升趋势，慢阻肺严重危害人类的健康。大约30%的慢阻肺急性加重患者原因不明，其中相当一部分可能与合并肺栓塞有关。慢阻肺急性加重时临床表现与肺栓塞相似，确诊肺栓塞主要依靠计算机断层扫描肺血管造影(CTPA)，常规检查不易排除或确认肺栓塞，易被漏诊或过度检查，影响患者预后或增加患者负担。目前对慢阻肺合并肺栓塞的研究尚不充分，为尽早准确的筛查慢阻肺急性加重患者是否合并肺栓塞，本文从流行病学、危险因素、临床特征、预后及治疗等方面来描述，使临床医生对慢阻肺合并肺栓塞有系统的认识，进而规范诊治流程，减少漏诊、误诊。

Abstract: The morbidity and mortality of chronic obstructive pulmonary disease (COPD) are on the rise, and COPD is seriously harmful to human health. About 30% of patients with acute exacerbstion of COPD have unknown causes, and a considerable number of them may be associated with pulmonary em-bolism. The clinical manifestations of acute exacerbation of COPD are similar to those of pulmonary embolism. The diagnosis of pulmonary embolism mainly depends on computed tomography pul-monary angiography (CTPA). Routine examination is not easy to exclude or confirm pulmonary embolism, and it is easy to be missed or overexamined, affecting the prognosis or increasing the burden of patients. At present, the research on COPD with pulmonary embolism is not enough. In order to screen the acute exacerbation of COPD with pulmonary embolism as soon as possible, this paper describes it from the aspects of epidemiology, risk factors, clinical characteristics, prognosis and treatment, so that clinicians have a systematic understanding of COPD patients with pulmonary embolism, standardize the process of diagnosis and treatment, and reduce missed diagnosis and misdiagnosis.