糖尿病并发肺血栓栓塞症的危险因素分析  

Analysis of risk factors of pulmonary embolism in diabetic patients

作　　者：谢昌辉[1] 朱琳[1] 潘展霞[2] 池莲祥[1] 姚国仙[1] 

机构地区：[1]南方医科大学附属宝安医院核医学科,广东省深圳518101 [2]深圳市宝安区中医院

出　　处：《中国基层医药》2010年第21期2960-2962,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨糖尿病（DM）并发肺血栓栓塞症（PE）的相关危险因素。方法对58例DM行双下肢99mTc．MAA深静脉显像（和／或超声检查）、肺灌注显像，同期获取空腹血糖、血胆固醇、血甘油三酯等实验室资料及年龄、病程、胸部症状（胸痛和呼吸困难）、下肢症状（肿胀、静脉喵张和DM足）、急性并发症（酮症酸中毒和高渗性昏迷）等临床资料。利用SPSS进行Logistic回归分析和）（2检验。结果28例DM（48．3％）并发下肢深静脉血栓（DVT），10例（17．2％）并发PE，有DVT的DM的PE发病率（32．1％）明显高于无DVT的DM（3．3％）（X2=6．53，P〈0．05）。单因素分析发现胸部症状、下肢症状、急性并发症3因素各自的PE发病率差异均有统计学意义（均P〈0．05），而年龄、病程、血糖、血胆固醇、血酯、血压、体重指数、糖尿病类型等因素各自PE发病率无明显差异（均P〉0．05）。多因素分析提示PE危险因素包括胸部症状（Score=13．316，P〈0，01）和下肢症状（Score=7．780，P〈0．01），而其他因素的危险度均无统计学意义（均P〉0．05）。结论对有胸部症状、下肢症状和／或下肢DVT的重症DM患者应尽早干预治疗，以减少PE发生。Objective To study the related risk factors of pulmonary embolism （PE） in diabetic patients. Methods 58 diabetic cases were underwent lower limbs 99mTc-MAA veins imaging （ and/or ultrasonography） and pulmonary perfusion imaging. The related laboratory data [ fasting blood glucose （FBG）, blood cholesterol, blood long chain triglycerides（LCT） ] and clinial informations [ age, disease courses, chest symptoms （chest pain and short of breathe） ,lower limbs symptoms （swellins,crooted veins and diabetic foot） and acute complication（ diabetic ketoacidosis and hyperosmolar non ketotie diabetic coma） ] were collected simultaneously. SPSS was used for X2-test and Logistic regression analysis. Results 28 patients （ 48.3% ） were showed to be with lower limbs deep vein thrombosis （DVT） and by 99Tcm-MAA imaging,10 cases（ 17.2% ） with PE. The PE ratio（32. 1% ） of the patients with DVT was more higher than no DVT（3.3% ） （X2 =6.53 ,P 〈0. 05）. Single factor analysis showed the PE ratios had significant difference to factors of chest symptoms,lower limbs symptoms and acute complication （ all P 〈 0.05 ）, respectively. There were no significant difference in other factors of age, disease courses, FBG, blood cholesterol, LCT, blood pressure, weight index, DM type （ all P 〉 0. 05 ）, respectively. Multiplicity analysis indicated ： the related risk factors of PE included chest symptoms （ Score = 13.316, P 〈 0. 01 ） and lower limbs symptoms （ Score = 7. 780, P 〈 0.01 ）. There were no significant differences in other factors（ all P 〉 0. 05 ） , respectively. Conclusion The serious DM with chest symptoms ,lower limbs symptoms and/or DVT could be controlled as early as possible by all kinds of treatment. It would decrease the PE complication.

关 键 词：糖尿病 肺栓塞 危险因素 多因素分析 

分 类 号：R563[医药卫生—呼吸系统] R587[医药卫生—内科学]