不同类型老年急性肺血栓栓塞症患者临床特征比较  

Comparison of clinical characteristics of different types of acute pulmonary embolism in elderly patients

作　　者：蒋蓉[1,3] 陈旭如 林丽萍 曾莹莹[1,3] 董越 王凯 黄琦慧 揭志军[1,3] 施劲东 Jiang Rong;Chen Xuru;Lin Liping;Zeng Yingying;Dong Yue;Wang Kai;Huang Qihui;Jie Zhijun;Shi Jindong(Department of Respiratory and Critical Care Medicine,Fifth People's Hospital of Shanghai City,Fudan University,Shanghai,200240;Department of Radiology,Fifth People's Hospital of Shanghai City,Fudan University,Shanghai,200240;Center of Community-Based Health Research(in preparation),Fudan University,Shanghai,200240,P.R.China)

机构地区：[1]复旦大学附属上海市第五人民医院呼吸与危重症医学科,上海200240 [2]复旦大学附属上海市第五人民医院影像医学科,上海200240 [3]复旦大学社区健康研究中心(筹),上海200240

出　　处：《老年医学与保健》2021年第1期51-55,共5页Geriatrics & Health Care

基　　金：闵行区自然科学研究课题项目(2020MHZ014)。

摘　　要：目的探讨不同类型老年急性肺血栓栓塞症(APTE)患者的临床特征。方法将2012年1月2018年5月上海市第五人民医院收治的78例APTE老年住院患者分为中央型组(n=42)和周围型组(n=36),比较2组的一般情况、危险因素、临床症状体征、实验室检查、影像学表现、危险分层和预后因素评分。结果2组一般情况和临床症状、体征差异无统计学意义。中央型组慢性肺病、深静脉置管、肺栓塞或深静脉血栓(DVT)病史比例多于周围型组(P<0.05);TNI升高、BNP升高、PaO2下降及双侧栓塞比例多于周围型组(P<0.05);心超肺动脉压力高于周围型组(P<0.05)。中央型组PESI评分、sPESI评分高于周围型组,综合评估高危比例多于周围型组,2组Bova评分差异无统计学意义(P>0.05)。结论中央型APTE老年患者慢性肺病、深静脉置管、肺栓塞或DVT病史比例及危险程度可能更高。Objective To investigate the clinical characteristics of different types of acute pulmonary embolism(APTE)in elderly patients.Methods 78 elderly APTE inpatients admitted to Fifth People’s Hospital of Shanghai City from January 2012 to May 2018 were enrolled and divided into central type group(n=42)and peripheral type group(n=36).The general conditions,risk factors,clinical symptoms and physical signs,laboratory examination,imaging features,risk stratification and prognostic score were compared between the two groups.Results There were no significant differences in baseline characteristics,clinical symptoms and physical signs between the two groups.The proportion of history of chronic lung disease,deep vein catheterization,pulmonary embolism or deep vein thrombosis in central type group was more than that in peripheral type group(P<0.05).The proportion of increased TNI,increased BNP,decreased PaO2 and bilateral embolism in the central group was more than that in the peripheral group(P<0.05).The pulmonary artery pressure of central type group was higher than that of central group(P<0.05).The PESI score and sPESI score of the central type group were higher than those of the peripheral type group,and the high-risk ratio of comprehensive assessment was more than that of the peripheral type group.There was no significant difference in Bova score between the two groups(P>0.05).Conclusion The proportion and risk of chronic lung disease,deep vein catheterization,pulmonary embolism or DVT may be higher in elderly patients with central APTE.

关 键 词：老年 肺栓塞 临床特点 危险因素 

分 类 号：R563.5[医药卫生—呼吸系统]