摘要: |
目的: 探讨住院患者急性肺血栓栓塞症(acute pulmonary thromboembolism,APTE)危险度分层的相关因素。方法: 选取2019年5月至2020年5月接受诊治的123例疑似为APTE的住院患者,分为栓塞组(n=93)和正常对照组(n=30)。将符合纳入标准的栓塞患者进行危险度分层和分组,中高危组60例,低危组33例。收集3组患者的临床资料,采用多因素logistic回归分析APTE的不同危险度与发病因素的相关性。结果: APTE中高危组、APTE低危组及正常对照组年龄,心房颤动、冠心病、下肢静脉血栓和脑血管病发生率,D-二聚体(D-Dimer,D-D)、纤维蛋白原(fibrinogen,FIB)、肺泡动脉氧分压差差异类有统计学意义(P<0.05)。心脏彩超表现中,APTE患者以肺动脉压增高占比最高(62.37%)。年龄、冠心病、脑血管病、下肢静脉血栓、D-D、FIB、肺泡动脉氧分压差为 APTE危险度分层独立影响因素(P<0.05)。受试者工作特征曲线(ROC)显示,年龄影响APTE危险度分层的ROC曲线下面积(AUC)为 0.621(95%CI 0.571~0.782);D-D影响APTE危险度分层的 AUC 为 0.646(95%CI 0.580~0.792);FIB的 AUC 为 0.887(95%CI 0.815~0.958);肺泡动脉氧分压差的 AUC 为 0.785(95%CI 0.686~0.885)。结论: 年龄、冠心病、脑血管病、下肢静脉血栓、D-D、FIB、肺泡动脉氧分压差为APTE危险度分层的影响因素,对预测中/高危APTE价值较高。 |
关键词: 急性肺血栓栓塞症 危险度分层 危险因素 |
DOI:10.12025/j.issn.1008-6358.2021.20210988 |
分类号:R563.5 |
基金项目:国家自然科学基金(81570073). |
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Analysis of related factors in risk stratification of acute pulmonary thromboembolism |
WU Min, LIANG Wen-qi, JIANG Lei, LIU Yue-e, WANG Mei-tang
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Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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Abstract: |
Objective: To investigate the correlation between risk stratification and risk factors in patients with acute pulmonary thromboembolism (APTE).Methods: Totally, 123 patients with suspected pulmonary thromboembolism were selected from May 2019 to may 2020 and divided into embolism group (n=93) and normal control group (n=30). The embolism patients were divided into high/medium risk group (n=60) and low-risk group (n=33), their medical records were collected, and the correlation between APTE risk stratification and the risk factors was analyzed by the multivariate logistic regression model.Results: There were statistical significant differences in the age,incidences of atrial fibrillation,coronary disease, lower extremity venous thrombosis, cerebrovascular disease, and the levels of D-D,FIB and A-aDO2 among three groups(P<0.05). In APTE patients, elevated pulmonary artery pressure accounted for the highest proportion (51.22%). Age, coronary disease, cerebrovascular disease, lower extremity venous thrombosis, D-D, FIB, and A-aDO2 independently affected the risk stratification of APTE (P<0.05). ROC curve results showed that AUC of age, D-D, FIB,and A-aDO2 for the diognosis of APTE was 0.621 (95% CI 0.571-0.782),0.646 (95% CI 0.580-0.792),0.887 (95% CI 0.815-0.958),and 0.785 (95% CI 0.686-0.885), respectively.Conclusions: Age, coronary disease, cerebrovascular disease, lower extremity venous thrombosis, D-D, FIB, and A-aDO2 are the influencing factors of risk stratification of APTE. They have a higher value in predicting high/medium risk APTE. |
Key words: acute pulmonary thromboembolism risk stratification risk factor |