Clinical characteristics and risk factors associated with prognosis of different types of pulmonary thromboembolism

Xiong Lei; Yang Xiangmei

doi:10.13406/j.cnki.cyxb.000727

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Clinical characteristics and risk factors associated with prognosis of different types of pulmonary thromboembolism

更新时间：2024-01-17

- Clinical characteristics and risk factors associated with prognosis of different types of pulmonary thromboembolism
- Journal of Chongqing Medical University Vol. 40, Issue 12, Pages: 1593-1598(2015)
- 作者机构：
  
  重庆医科大学附属第一医院呼吸内科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000727
  CLC： R563.5
- Published：2015，
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[1]熊蕾,杨相梅.不同类型肺血栓栓塞临床特点及预后相关因素分析[J].重庆医科大学学报,2015,40(12):1593-1598.

Xiong Lei, Yang Xiangmei. Clinical characteristics and risk factors associated with prognosis of different types of pulmonary thromboembolism. [J]. Journal of Chongqing Medical University 40(12):1593-1598(2015)
[1]熊蕾,杨相梅.不同类型肺血栓栓塞临床特点及预后相关因素分析[J].重庆医科大学学报,2015,40(12):1593-1598. DOI： 10.13406/j.cnki.cyxb.000727.

Xiong Lei, Yang Xiangmei. Clinical characteristics and risk factors associated with prognosis of different types of pulmonary thromboembolism. [J]. Journal of Chongqing Medical University 40(12):1593-1598(2015) DOI： 10.13406/j.cnki.cyxb.000727.

摘要

目的:比较单发型肺血栓栓塞（pulmonary thromboembolism

PTE）与PTE合并外周静脉血栓患者的临床资料

来探索影响二者疾病预后的相关因素及临床发病特点。方法:将PTE患者按是否合并外周静脉血栓分为两组

对其临床资料进行回顾性分析。结果:134例PTE患者中

单发型PTE61例

合并有外周静脉血栓的PTE有73例

单发组年龄明显高于合并组;PTE的临床表现多样而缺乏特异性

单发组在心悸（P=0.006）方面较显著;实验室及影像学检查中

单发组在D-Dimer（P=0.029）、Pa O2（P=0.036）及心脏彩超异常（P

0.001）项目中较合并组明显高;简化肺栓塞严重指数（simplified pulmonary embolism severity index

SPESI）评分中

单发组所占高危组（P=0.015）比例较合并组显著;查尔森合并症指数（Charlson comorbidity index

CCI）中

单发组在合并心梗（P=0.040）和慢性肺病（P=0.027）方面高于合并组

有统计学意义。经多因logistic回归分析

影响单发组疾病预后的影响因素有纤维蛋白（原）降解物（fibrinogen degradation product

FDP）（OR=1.029

95%CI=1.002

.057

P=0.036）

N-末端脑钠肽前体（N-terminal pro brain natriuretic peptide

NT-pro-BNP）（OR=1.000

95%CI=1.000

.001

P=0.037）和恶性肿瘤（OR=25.839

95%CI=2.439

73.760

P=0.007）

影响合并组疾病预后的影响因素为恶性肿瘤（OR=14.571

95%CI=3.843

5.254

0.001）。结论:在本研究中

单发型PTE较合并型PTE多见于年龄更偏大的老年内科患者。临床表现多样化

但单发型尤以心悸为主;通过比较

单发型PTE预后的严重性不亚于甚至可能比合并组PTE严重。恶性肿瘤同为导致两种类型肺栓塞不良预后的因素

FDP、NT-pro-BNP还是单发型肺栓塞不良预后的危险因素。

Abstract

Objective:To compare the clinical data between single type pulmonary thromboembolism(PTE) and PTE complicated with peripheral venous thrombosis and to identify the clinical characteristics and risk factors associated with prognosis of the two types of PTE. Methods:A retrospective study was performed on 134 patients with PTE hospitalized in the First Affiliated Hospital of Chongqing Medical University from January 2012 and December 2013. Results:There are 134 PTE patients

61 in single type PTE group and 73 in PTE complicated with peripheral venous thrombosis group. The age was higher in single type PTE group than in PTE complicated with peripheral venous thrombosis group. Although the clinical manifestations of PTE were varied

they lacked specificity. Palpitation was more obvious in single type PTE group(P=0.006) than in PTE complicated with peripheral venous thrombosis group. In terms of laboratory and imaging examination

D-Dimer(P=0.029)

Pa O2(P=0.036) and cardiac ultrasound abnormalities(P<0.001) were more obvious in single type PTE group;and in terms of simplified Pulmonary Embolism Severity Index(SPESI) score and Charlson comorbidity index(CCI)

single type PTE group were statistically significant higher than those of PTE complicated with peripheral venous thrombosis group. Logistic regression model showed the factors affecting the prognosis of single type PTE group were fibrinogen degradation product(FDP)(OR =1.029

95% CI =1.002 to 1.057)

N-terminal pro brain natriuretic peptide(NT-pro-BNP)(OR =1.000

95%CI=1.000 to 1.001) and malignant tumor(OR=25.839

95%CI=2.439-273.760);the factor affecting the prognosis of PTE complicated with peripheral venous thrombosis group was the malignant tumor group(OR=14.571

95%CI=3.843 to 55.254).Conclusion:Single type PTE is more likely to happy in older people than PTE complicated with peripheral venous thrombosis. Though clinical manifestations of PTE are various

the main symptom of single type PTE is palpitation. The prognosis of single type PTE is severe than that of PTE complicated with peripheral venous thrombosis. The common risk factor of the two types of PTE is malignant tumor;fibrinogen degradation product(FDP) and N- terminal pro brain natriuretic peptide(NT-pro-BNP) are also the other two risk factors for single type PTE.

关键词

肺血栓栓塞症静脉血栓栓塞症临床特点预后

Keywords

pulmonary thromboembolismvenous thromboembolismclinical characteristicsprognosis

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