Shapira-Rootman Mika, Beckerman Marinella, Soimu Uri, Nachtigal Alicia, Zeina Abdel-Rauf
Department of Radiology, Hillel Yaffe Medical Center, P.O.B. 169, Hadera, 38100, Israel.
Emerg Radiol. 2015 Jun;22(3):257-60. doi: 10.1007/s10140-014-1280-7. Epub 2014 Oct 26.
The clinical diagnosis of acute pulmonary embolism (PE) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) is often difficult due to the similarity in the presenting symptoms of the two conditions. The purpose of this study was to determine the prevalence of PE in patients with acute exacerbation of COPD. Forty-nine consecutive patients admitted to our medical center for acute exacerbation of COPD were investigated for PE (whether or not clinically suspected), following a standardized algorithm based on D-dimer testing and computed tomography pulmonary angiography (CTPA). PE was ruled out by a D-dimer value <500 μg/L in 20 (41 %) patients and by negative CTPA in 40 (82 %). PE was confirmed in 9 patients. The prevalence of PE was 18 %. One patient with normal D-dimer had PE. Presenting symptoms and signs were similar between patients who did and did not have PE. PE was detected in 18 % of COPD patients who were hospitalized for an acute exacerbation. This finding supports the systematic evaluation of PE in hospitalized COPD exacerbated patients.
慢性阻塞性肺疾病（COPD）急性加重期患者的急性肺栓塞（PE）临床诊断往往很困难，因为这两种病症的症状相似。本研究的目的是确定COPD急性加重期患者中PE的患病率。对连续49例因COPD急性加重入住我们医疗中心的患者，按照基于D-二聚体检测和计算机断层扫描肺动脉造影（CTPA）的标准化方案进行PE检查（无论临床上是否怀疑）。20例（41%）患者的D-二聚体值<500μg/L，40例（82%）患者的CTPA结果为阴性，从而排除了PE。9例患者确诊为PE。PE的患病率为18%。1例D-二聚体正常的患者患有PE。有PE和没有PE的患者的症状和体征相似。因急性加重住院的COPD患者中18%检测出PE。这一发现支持对住院的COPD急性加重患者进行PE的系统评估。
