不同危险分层肺血栓栓塞患者的影响因素、临床表现及血脂水平研究

发布时间：2018-04-20 15:43

  本文选题：肺血栓栓塞 + 危险分层　； 参考：《中国全科医学》2017年25期

【摘要】：目的探讨肺血栓栓塞(PTE)患者危险分层的影响因素以及不同危险分层PTE患者的临床表现及血脂水平,为临床PTE危险分层和制定合理治疗方案提供依据。方法选取2010—2014年中国医科大学附属盛京医院收治的PTE患者60例,依据2014年欧洲心脏病学会(ESC)制定的《急性肺栓塞诊断及管理指南》中提出的PTE的危险分层标准,将纳入患者分为高/中危组(n=35)和低危组(n=25)。收集两组患者的临床资料,比较两组患者的基本情况、临床表现及血脂水平,采用多因素Logistic回归分析探讨PTE危险分层的影响因素。结果两组患者年龄比较,差异有统计学意义(P0.05);男性比例及吸烟、饮酒、高血压、冠心病、糖尿病、脑血管疾病、下肢深静脉血栓(DVT)、近期手术、创伤、长期卧床史比较,差异均无统计学意义(P0.05)。年龄是PTE危险分层的影响因素[OR=1.145,95%CI(1.059,1.238),P0.05]。两组心悸、咯血或痰中带血、晕厥、濒死感发生率比较,差异有统计学意义(P0.05);呼吸困难、咳嗽、胸痛、三联征发生率比较,差异无统计学意义(P0.05)。两组心动过速、颈静脉充盈发生率比较,差异有统计学意义(P0.05);下肢肿胀、体温升高、呼吸急促、湿Up音、发绀、第二心音亢进、哮鸣音发生率比较,差异无统计学意义(P0.05)。两组患者血清总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、载脂蛋白AⅠ、载脂蛋白B水平比较,差异均无统计学意义(P0.05)。结论高龄是发生高/中危PTE的危险因素。若PTE患者存在心悸、晕厥、濒死感、心动过速及颈静脉充盈等临床症状及体征,临床中需要警惕高/中危PTE的发生。
[Abstract]:Objective to investigate the influencing factors of risk stratification in patients with pulmonary thromboembolism (PTE) and the clinical manifestations and blood lipid levels of patients with PTE with different risk stratification, so as to provide evidence for clinical risk stratification of PTE and rational treatment plan. Methods A total of 60 patients with PTE were selected from Shengjing Hospital affiliated to China Medical University from 2010 to 2014. According to the risk stratification criteria for acute pulmonary embolism (PTE) developed by the European Society of Cardiology in 2014, the guidelines for diagnosis and Management of Acute Pulmonary embolism (APE) were used. The patients were divided into high / moderate risk group (n = 35) and low risk group (n = 25). The clinical data of the two groups were collected, and the basic condition, clinical manifestation and blood lipid level of the two groups were compared. The risk factors of PTE risk stratification were analyzed by multivariate Logistic regression analysis. Results there were significant differences in age between the two groups (P 0.05), smoking, drinking, high blood pressure, coronary heart disease, diabetes, cerebrovascular disease, DVT, recent operation, trauma, long-term bed rest history. The difference was not statistically significant (P 0.05). Age was the influencing factor of PTE risk stratification. The incidence of palpitation, hemoptysis or sputum with blood, syncope and near-death were significantly different between the two groups (P 0.05), but the incidence of dyspnea, cough, chest pain and triple sign were not significantly different (P 0.05). There was no significant difference in the incidence of tachycardia and jugular vein filling between the two groups (P 0.05), swelling of lower limbs, elevation of body temperature, shortness of breath, wet up, cyanosis, hyperactivity of the second cardiac sound and wheezing. There was no significant difference in serum total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apolipoprotein A 鈪，

本文编号：1778394