22例结缔组织病合并急性肺栓塞患者的临床特点  

Clinical features of 22 connective tissue disease patients complicated with acute pulmonary embolism

作　　者：洪学志 陶宁文 王亚慧 刘凯亮 莫海露 付晓楠 莫汉有[1] HONG Xue-zhi;TAO Ning-wen;WANG Ya-hui;LIU Kai-liang;MO Hai-lu;FU Xiao-nan;MO Han-you(Department of Rheumatology and Immunology,Affiliated Hospital of Guilin Medical University,Guilin 541001,Guangxi,China)

机构地区：[1]桂林医学院附属医院风湿免疫科,广西桂林市541001

出　　处：《广西医学》2022年第16期1844-1846,1858,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81760298);广西自然科学基金(2020GXNSFBA297149)。

摘　　要：目的分析结缔组织病(CTD)合并急性肺栓塞患者的临床特点。方法回顾性分析22例CTD合并肺栓塞患者的临床资料,收集患者的一般资料、实验室检查结果,并采用简化Wells评分、简化版Geneva评分对患者进行肺栓塞的危险分层。结果22例患者中男性7例、女性15例,年龄11~76(48.5±21.4)岁,其中系统性红斑狼疮5例、血管炎5例、干燥综合征4例、类风湿关节炎4例、未分化结缔组织病2例、抗合成酶综合征及抗磷脂综合征各1例;7例伴有下肢静脉血栓形成。临床主要表现为胸痛8例,呼吸困难8例,心动过速8例及咳嗽7例;漏诊9例(40.9%)。根据简化Wells评分,肺栓塞高度可能4例(18.2%);根据简化版Geneva评分,肺栓塞高度可能7例(31.8%)。结论CTD患者出现呼吸困难、胸痛等呼吸道症状且呼吸困难原因不明时,需考虑急性肺栓塞可能,建议给予患者进行简化Wells评分及简化版Geneva评分,有助于及时发现急性肺栓塞。Objective To analyze the clinical features of connective tissue disease(CTD)patients complicated with acute pulmonary embolism.Methods The clinical data of 22 CTD patients complicated with pulmonary embolism were retrospectively analyzed.The general data,laboratory examination results were collected,and simplified Wells score,revised Geneva score were employed to perform the risk stratification of pulmonary embolism.Results Among the 22 patients,7 cases were male and 15 cases were female,with age of 11-76(48.5±21.4)years old.Among them,there were 5 cases of systemic lupus erythematosus,5 cases of vasculitis,4 cases of Sjogren′s syndrome,4 cases of rheumatoid arthritis,2 cases of undifferentiated connective tissue disease,1 case of antisynthetase syndrome,and 1 case of antiphospholipid syndrome;furthermore,there were 7 cases complicated with the formation of lower extremities vein thrombosis.The main clinical manifestations were chest pain in 8 case,dyspnea in 8 cases,tachycardia in 8 cases,and cough in 7 cases.Nine cases were misdiagnosed(40.9%).According to the simplified Wells score,4 cases(18.2%)were determined as pulmonary embolism with high probability,and according to revised Geneva score,7 cases(31.8%)were determined as pulmonary embolism with high probability.Conclusion When the CTD patients have respiratory symptoms in terms of dyspnea and chest pain,etc.and have unexplained dyspnea,the possibility of acute pulmonary embolism should be considered.It is suggested to perform the simplified Wells score and revised Geneva score in those patients,which is beneficial to detect pulmonary embolism in time.

关 键 词：结缔组织病 急性肺栓塞 临床特点 简化Wells评分 简化版Geneva评分 

分 类 号：R563.5[医药卫生—呼吸系统] R593.2[医药卫生—内科学]