急性肺栓塞的临床表现及治疗对预后的影响  

The influence of clinical characteristics and treatment to prognosis on patients with acute pulmonary embolism

作　　者：纵雪梅[1] 王玉芹[2] 陈玉玲[3] 许铁[1] 张青卿[1] 

机构地区：[1]徐州医学院附属医院急救中心,江苏徐州221002 [2]山东省青岛市市立医院 [3]徐州医学院附属医院呼吸科,江苏徐州221002

出　　处：《中国现代医药杂志》2013年第9期1-4,共4页Modern Medicine Journal of China

摘　　要：目的通过分析急性肺栓塞（acutepulmonaryembolism，APE）患者的临床资料，探讨影响APE患者预后的指标。方法对我院2005年1月～2009年3月诊断为APE的125例住院患者进行回顾性分析。结果全组APE患者中男女比为1．12：1；平均年龄（58．2＋15．2）岁，40岁以上患者占87．2％，年住院人数呈上升趋势，年死亡率呈下降趋势。有基础心肺疾病、下肢深静脉血栓形成（deepvenous thrombosis，DVT）是APE发生的主要危险因素。危险因素I〉2个组患者的住院死亡率、不良事件发生率和随访3个月死亡率显著高于危险因素〈2个组（P〈0．01），受试者工作特征曲线（receiveroperatorchar-acteristiccurve，ROC曲线）显示其判断死亡的最佳分界点是1．5。未做抗凝或溶栓治疗组患者的住院死亡率显著高于抗凝治疗组或溶栓＋抗凝治疗组（P〈0．01）。结论①APE的发病年龄集中于中老年，住院人数有增加趋势，年住院死亡率显著下降；②原有心肺疾病及DVT是发生APE的主要危险因素，且危险因素个数是预测APE患者转归的独立指标；③抗凝治疗或溶栓＋抗凝治疗可以显著降低APE患者的住院死亡率。Objective To investigate the predieators of prognosis of patients with acute pulmonary embolism （APE） by analyzing the clinical date of patients with APE. Methods Used retrospective analytical methods to analyze the clinical data of 125 patients with APE,who were hospitalized in our hospital from Jan 2005 to Mar 2009. Results In the whole group of patients with APE ,the ratio of male to female was 1.12：1. The average age was （58.2±15.2） years old. Patients ove 40 years old with APE accounted for 87.2%. The number of hospitalizations showed a upward trend,while the mortality showed a downward trend. Heart and lung disease and lower extremity deep vein thrombosis（DVT） were the main risk factors of APE. The mortality, incidence of adverse events and follow-up 3 months mortality in group of patients with the number of risk factors ≥ 2 were sig- nificantly higher than that of control group （P〈0.01）. Receiver operator characteristic curve （ROC curve） showed the best cut-off point of the number of risk factors for judging of death was 1.5. The mortality in group of patients without anticoagulant or thrombolytic therapy was significantly higher than that of group of patients with anticoagulant therapy or thrombolytic puls anti- coagulant therapy （P〈0.01）. Conclusion ①APE occurs mostly in middle-aged. The number of hospitalizations shows a up- ward trend,while the mortality shows a downward trend. ②Heart and lung disease,DVT were the main risk factors of APE. The number of risk factors was an independent predictor of the prognosis of APE patients. ③Anticoagulant therapy or thrombolytie puls anticoagulant therapy can significantly reduce the mortality of the patients with APE.

关 键 词：急性肺栓塞 临床 危险因素 预后 

分 类 号：R563.5[医药卫生—呼吸系统]