煤工尘肺患者合并静脉血栓栓塞症的危险因素分析  

Analysis of risk factors of patients with coal worker's pneumoconiosis complicated with venous thromboembolism

作　　者：化静 陈亮[1] 张建红[1] 石金凤 李瑶 HUA Jing;CHEN Liang;ZHANG Jianhong;SHI Jinfeng;LI Yao(Department of Respiratory and Critical Care,Beijing Jingmei Group General Hospital,Beijing 102300,China)

机构地区：[1]北京京煤集团总医院呼吸与危重症医学科,102300

出　　处：《心肺血管病杂志》2022年第3期254-256,274,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究煤工尘肺患者合并静脉血栓栓塞症(VTE)的临床危险因素,以便于更早地发现煤工尘肺合并VTE。方法:对2017年1月至2019年12月,北京京煤集团总医院收治的156例煤工尘肺患者,均完善螺旋CT肺动脉造影(CTPA)及下肢静脉超声检查,根据检查结果分为煤工尘肺组和煤工尘肺+VTE组,比较两组患者在发生VTE的一般资料、体征以及实验室检查结果的差异,采用单因素和多因素Logistic回归分析探索煤工尘肺+VTE发病相关危险因素。结果:156例煤工尘肺患者中,32例(20.5%)合并VTE,124例(79.5%)煤工尘肺患者未合并VTE,两组危险因素差异有统计学意义的有:既往血栓病史、制动/卧床时间≥3d、下肢不对称水肿、D-Dimer、BNP水平。多因素Logistic回归分析显示,既往血栓病史、制动/卧床时间≥3d、不对称下肢水肿及D-Dimer≥1500mg/人、BNP≥1200ng/人为煤工尘肺合并VTE的危险因素。结论:煤工尘肺患者合并VTE的发生率为20.9%,多因素共同参与煤工尘肺合并VTE的发生,临床上既往血栓病史、制动或卧床≥3天、下肢不对称水肿及D-Dimer、BNP水平升高时,尽快完善相关检查明确是否伴有VTE。Objective:The study aims to explore the clinical risk factors of patients with coal worker's pneumoconiosis complicated with venous thromboembolism(VTE),in order to detect coal worker's pneumoconiosis complicated with VTE earlier.Methods:CT pulmonary angiography CTPA and lower limb venous ultrasonography were performed for 156 patients with coal worker's pneumoconiosis treated in Beijing Jingmay Group General Hospital from January 2017 to December 2019.According to the results of examinations,patients were divided into the coal worker's pneumoconiosis group and the coal worker's pneumoconiosis+VTE group.The general information,physical signs and laboratory examination results of patients were compared between the two groups,and univariate and multivariate logistic regression analysis were conducted to explore the risk factors related to the incidence of coal worker's pneumoconiosis+VTE.Results:Among 156 patients with coal worker's pneumoconiosis,32 cases(20.51%)were complicated with VTE,and 124 cases(79.5%)were not complicated with VTE.There were statistically significant differences in risk factors between the two groups:Previous history of thrombosis,duration of immobilization/bed rest≥3 days,asymmetric lower extremity edema,D-dimer,and BNP levels.Multivariate logistic regression analysis showed that previous history of thrombosis,immobilization/bed stay≥3 days,asymmetric lower limb edema,D-dimer≥1500 ng/mL,BNP≥1200 pg/mL constitute the risk fators for coal worker's pneumoconiosis complicated with VTE.Conclusions:The incidence of coal workers'pneumoconiosis complicated with VTE is 20.9%.Multiple factors are involved in the occurrence of coal workers'pneumoconiosis complicated with VTE.When patients show clinical history of thrombosis,immobile or bed rest≥3 days,asymmetric edema of lower extremities,or increased d-dimer and BNP levels,relevant examinations should be conducted early to determine whether there is VTE.

关 键 词：静脉血栓栓塞 煤工尘肺 危险因素 

分 类 号：R56[医药卫生—呼吸系统]