摘要
目的探讨常见呼吸道疾病发生肺动脉栓塞(PE)的危险因素,减少常见呼吸道疾病常见病漏诊或误诊肺栓塞的概率。方法回顾性分析2010年1月至2016年12月期间患者125例,平均年龄(70.33±12.01)岁,分为确诊肺栓塞组和非肺栓塞组,进行两组基本情况、基础疾病、临床特点及辅助检查结果比较,并探讨肺栓塞形成的危险因素及确诊肺栓塞的D二聚体的临界值。结果 125例患者中,确诊肺栓塞45例,合并卒中史对于诊断肺动脉栓塞有统计学意义(χ2值11.671,P<0.01)。呼吸困难、下肢水肿、房颤临床特点与肺动脉栓塞形成有相关性(χ2值14.468-20.638,P<0.01)。血清D二聚体升高与肺栓塞有明确相关性(t值-4.132,P<0.01)。常见呼吸道疾病最终确诊PE或合并PE的危险因素为呼吸困难(OR值28.700,95%CI:1.759-11.845,P<0.01)、血D二聚体值(OR值23.522,95%CI:1.149-3.017,P<0.05)。确诊肺栓塞的D二聚体的最佳临界值为1.950ug/m L。结论血清D二聚体值大于1.95ug/m L且存在呼吸困难症状者为呼吸道疾病发生肺栓塞的危险因素,需及时行肺动脉CT(CTPA)检查。
Objective To study the risk of pulmonary embolism （PE ） with common respiratory disease and to reduce the possibility of missed diagnosis or misdiagnosis for PE. Methods 125 cases [ aged 32 to 90 years, mean （70. 33 ± 12. 01） ] were recruited from January 2010 to December 2016 in the sixth affiliated people,s hospital of Shanghai Jiaotong University. The patients were classified as the PE positive and the PE negative group. The base situation, underlying disease, clinical characters and accessory examination were compared between the two groups. The related risk factors for PE were analyzed and the cut off value of D dimmer were determined. Results Within the 125 cases, the incidence of PE was 45 cases. The patients complicated with apoplexy had significant in the diag-nosis of PE （）（2 =11. 671, P〈0. 01）. The factor of dyspnea, edema of lower extremity and atrial fibrillation had sig-nificant difference between the two groups （ X2 - 14. 468 - 20. 638 , P 〈 0. 01） . The value of D dimmer was signifi-cant difference between the two groups （ t = - 4 . 132,P 〈0. 0 1 ） . Multiple regression analysis showed that dyspnea （0^=28.700,95% Cl： 1.759 -1 1 .8 4 5 , P〈0 .0 1 ） and increased D dimmer （OR =23. 522, 95% C l： 1 .1 4 9 -3. 017, P 〈0. 05） were the risk factors. The cut-off of PE diagnosis was 1. 950. Conclusion Serum D dimmer over than 1. 95ug/mL and the symptom of dyspnea were the risk factors for PE in respiratory patients, which needs the necessary examination of computed tomographic pulmonary angiography （CTPA）
出处
《临床肺科杂志》
2017年第10期1813-1816,共4页
Journal of Clinical Pulmonary Medicine
关键词
肺栓塞
呼吸道疾病
D二聚体
pulmonary embolism
respiratory disease
D dimmer
