摘要
目的调查住院肺血栓栓塞症(pulmonary thromboembolism,PTE)患者合并冠心病(coronary heartdisease,CHD)的发病率,研究合并CHD对于PTE患者病情严重程度的影响,同时比较临床干预的差异。方法分析了48例合并CHD的住院PTE患者的一般情况,吸烟指数,栓塞面积,是否合并高血压和下肢深静脉血栓(deep ve-nous thrombosis,DVT),动脉血气分析结果,心肌坏死标记物和所接受的临床干预措施,并与对照组30例不合并CHD的PTE患者进行比较。结果 15.3%的住院PTE患者合并CHD,合并CHD的住院PTE患者静息时未吸氧情况下动脉血氧分压(PaO2)低于未合并CHD的PTE患者,差异有统计学意义[(73.2±8.6)mm Hg vs.(78.6±6.1)mm Hg,P=0.015];栓塞累计肺段数两组相比,合并CHD的PTE患者累及肺段多于不合并CHD的患者,差异有统计学意义[(7.1±3.4)个vs.(5.1±3.2)个,P=0.029];临床干预方面,两组均采用低分子肝素序贯华法林和(或)溶栓治疗,合并CHD的PTE患者在此基础上应用抗血小板药物治疗。结论住院PTE患者合并CHD的发病率较高,合并CHD的PTE患者肺栓塞病情较重,临床上需要采取以低分子肝素序贯华法林和抗血小板药物为主的综合治疗。
Objective To determine the prevalence of coronary atherosclerotic heart disease（CHD） in hospitalized pulmonary thromboembolism（PTE） patients and to examine its impact on the severity and management of the disease among patients with PTE. Methods Data including general information,cigarette smoking index,thromboembolism area,complication with hypertension and deep venous thrombosis（DVT） of 48 PTE patients with complicated CHD were analyzed and compared with those of 30 PTE patients without CHD. Results CHD was observed in 15.3% of the PTE patients.PaO2 values[（73.2±8.6） mm Hg vs.（78.6±6.1） mm Hg,P=0.015] and number of affected lung segments [（7.1±3.4） vs.（5.1±3.2）,P=0.029] in PTE patients with complicated CHD were higher than in PTE patients without CHD.All patients received low-molecular-weight heparin followed by warfarin therapy and/or thrombolysis treatment.Anti-platelet drug treatment was also used in PTE patients with CHD. Conclusion Prevalence of CHD in patients diagnosed with PTE is high.PTE patients with CHD show more serious conditions than their counterparts without CHD.Treatments including low-molecular-weight heparin,long-term warfarin and anti-platelet drugs therapy should be used in these patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第31期3577-3579,共3页
Chinese General Practice
关键词
肺血栓栓塞症
冠心病
疾病特征
Pulmonary thromboembolism
Coronary heart disease
Disease attributes
