综合内科142例老年人肺栓塞临床特点  

Risk Factors of Pulmonary Embolism in the Elderly Patients

作　　者：马育霞[1] 刘毅 王鹏升[1] 李英[1] 赵红英[1] 刘云峰[1] 

机构地区：[1]河北省沧州市中心医院老年内科,沧州061001 [2]河北省沧州监狱医院内科,沧州061001

出　　处：《中国医药导刊》2016年第5期444-445,447,共3页Chinese Journal of Medicinal Guide

基　　金：沧州市科技基金项目;编号:1213056ZD;课题名称wells评分在疑似肺栓塞患者筛选的价值;编号:131302071;课题名称:不同性别;年龄肺栓塞患者临床症状;相关危险因素研究及诊疗对策

摘　　要：目的:总结老年肺栓塞住院病人的临床特点以及抗凝治疗前后D-二聚体的变化。方法:选择我院收治的肺栓塞患者256例,观察组分为老年组142例,非老年组114例,比较临床表现和危险因素差异,同时观察抗凝治疗后血浆D-二聚体含量的变化。并选取健康对照组200例,采用多元Logistic回归模型分析老年人肺栓塞危险因素。结果:观察2组呼吸困难、咳嗽、胸闷的患病率分别是85.2%和81.6%,72.5%和71.1%,57%和62.3%,两组比较无统计学差异,但非老年组咯血的患病率(27.2%),高于老年组(9.9%),差异有统计学意义(P=0.000);老年组无症状(12.7%)多于非老年组(2.6%),有统计学意义(P=0.004)。老年组的危险因素多见于糖尿病、高血压、慢性阻塞肺疾病和既往脑卒中。抗凝治疗后,两组患者D-二聚体均较治疗前明显降低,差异有统计学意义。老年组的独立危险因素分别为COPD、既往深静脉血栓病史、恶性肿瘤和既往脑卒中;非老年组为既往深静脉血栓史。结论:老年人急性肺栓塞的临床表现多不典型,现呼吸困难仍为最常见的临床表现。COPD、恶性肿瘤、既往深静脉血栓和脑卒中均为老年人急性肺栓塞的独立危险因素,需注意加以鉴别。Objective: To summarize the clinical feature and risk factors of patients suffering from pulmonary embolism(PE) in the elderly patients,and explore the change of D-dimer after anticoagulant therapy.Methods:256 patients with suspected PE were admitted from January 2009 to May 2015 in the Cangzhou Central Hospital,acomparison of clinical features and risk factors,between the elderly groups and non-elderly.The change of D-dimer content was determined before and 3-day after anticoagulant therapy in two groups.Results:The most important risk factor for the elderly patients was stroke.but for non-elderly patients was DVT.After anticoagulant therapy,the decreasing level of D-dimer was significant statistical differences in two groups. Conclusion:Between the elderly and non-elderly groups,the main clinical manifestations were similar.The main symptoms is dyspnea.The risk factors of elderly patients is COPD, therioma, DVT and stroke.After anticoagulant therapy,the content of D-dimer is lower than 3-day ago.D-dimer test is a good screening test for PE. (P<0.05).

关 键 词：肺栓塞 老年人 危险因素 D-二聚体 抗凝 

分 类 号：R563.5[医药卫生—呼吸系统]