肺栓塞患者发热的临床研究
发布时间：2019-06-11 15:43
【摘要】：[目的]通过观察肺栓塞(pulmonary embolism, PE)患者发热情况以及实验室检查指标:降钙素原(procalcitonin,PCT)、白介素-6(interleukin-6,IL-6)、超敏 C 反应蛋白(High sensitive c-reactive protein,hs-CRP)水平,探索PE患者发热的临床特点及可能机制。[方法]回顾性分析昆明医科大学第二附属医院2015年3月至2016年10月于呼吸内科一病区住院经256层螺旋CT肺动脉造影明确诊断为PE患者305例,筛选出PE合并发热患者59例作为实验组(A组),随机选取不合并发热的PE患者59例(B组)、同期住院的有发热症状的社区获得性肺炎(Community acquired pneumonia,CAP)患者 59 例(C 组)作为对照组。所有患者均是在入院当时立即测体温,抽取外周静脉血进行PCT、IL-6、hs-CRP的检测,比较三组患者入院时的体温(temperature,T)、PCT、IL-6、hs-CRP水平的差异。并且采用简化版的肺栓塞严重程度指数(Simplfied Pulmonary Embolism Severity Idex,SPESI)评分对 PE 发热患者进行危险程度评分,评估体温与PE危险程度的关系。[结果]1.在305例肺栓塞患者中,由肺栓塞本身引起发热者59例(19.3%),体温范围在37. 2℃-39. 7℃之间,其中低热患者44.1%,中等程度发热患者37. 3%,高热患者18. 6%;发热程度在PE低危、高危程度的分布,无统计学差异(P0. 05)。2.A、C组的T、PCT、IL-6、hs-CRP水平均明显高于B组,差异有统计学意义(P0.01)。C组T较A组高,差异有统计学意义(P0.05); A、C组PCT、IL-6、hs-CRP水平比较,无统计学意义(P0.05)。[结论]1.19. 3%的肺栓塞患者可出现发热,发热以低、中热为主;发热程度与PE的危险程度无关。2.肺栓塞发热患者的体温明显低于CAP患者;肺栓塞发热患者的降钙素原、白介素6、超敏C反应蛋白水平均较不发热患者明显升高,与社区获得性肺炎发热患者相比较,无明显差异。肺栓塞患者发热的机制可能为炎症反应过程。
[Abstract]:[objective] to explore the clinical characteristics and possible mechanism of fever in patients with pulmonary embolism (pulmonary embolism, PE) by observing the levels of procalcitonin (procalcitonin,PCT), IL-6 (interleukin-6,IL-6) and high-sensitive C-reactive protein (High sensitive c-reactive protein,hs-CRP) in patients with pulmonary embolism. [methods] from March 2015 to October 2016, 305 patients with PE were diagnosed by 256slice spiral CT pulmonary angiography in the second affiliated Hospital of Kunming Medical University. 59 patients with PE complicated with fever were selected as experimental group (group A). 59 patients with PE without fever (group B) were randomly selected. (Community acquired pneumonia, with fever symptoms was hospitalized at the same time. 59 patients with CAP (group C) served as control group. All patients measured their body temperature immediately at the time of admission, and peripheral venous blood was taken for PCT,IL-6,hs-CRP detection. The differences of body temperature (temperature,T) and PCT,IL-6,hs-CRP level among the three groups at admission were compared. The simplified pulmonary embolism severity index (Simplfied Pulmonary Embolism Severity Idex,SPESI) score was used to evaluate the risk degree of PE febrile patients, and the relationship between body temperature and PE risk was evaluated. [result] 1. Of 305 patients with pulmonary embolism, 59 (19.3%) had fever caused by pulmonary embolism itself, with a temperature range of 37. 5%. 2 鈩，
本文编号：2497303
[Abstract]:[objective] to explore the clinical characteristics and possible mechanism of fever in patients with pulmonary embolism (pulmonary embolism, PE) by observing the levels of procalcitonin (procalcitonin,PCT), IL-6 (interleukin-6,IL-6) and high-sensitive C-reactive protein (High sensitive c-reactive protein,hs-CRP) in patients with pulmonary embolism. [methods] from March 2015 to October 2016, 305 patients with PE were diagnosed by 256slice spiral CT pulmonary angiography in the second affiliated Hospital of Kunming Medical University. 59 patients with PE complicated with fever were selected as experimental group (group A). 59 patients with PE without fever (group B) were randomly selected. (Community acquired pneumonia, with fever symptoms was hospitalized at the same time. 59 patients with CAP (group C) served as control group. All patients measured their body temperature immediately at the time of admission, and peripheral venous blood was taken for PCT,IL-6,hs-CRP detection. The differences of body temperature (temperature,T) and PCT,IL-6,hs-CRP level among the three groups at admission were compared. The simplified pulmonary embolism severity index (Simplfied Pulmonary Embolism Severity Idex,SPESI) score was used to evaluate the risk degree of PE febrile patients, and the relationship between body temperature and PE risk was evaluated. [result] 1. Of 305 patients with pulmonary embolism, 59 (19.3%) had fever caused by pulmonary embolism itself, with a temperature range of 37. 5%. 2 鈩，
本文编号：2497303
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