高原地区肺动脉血栓栓塞的相关影响因素

Related Risk Factors of High-Altitude Pulmonary Thromboembolism

目的探讨高原地区肺动脉血栓栓塞(PTE)的相关影响因素。方法选择我院治疗的200例PTE患者,其中生活在海拔2500~4500m高海拔地区的100例患者为观察组,生活在1500~2499m低海拔地区100例患者为对照组。调查两组患者性别、年龄、民族等基本人口学资料,并进行血常规等常规检查以及病史调查等,单因素分析高原地区发病的危险因素,多因素Logistic回归分析其独立危险因素。结果单因素分析显示红细胞水平、血红蛋白(hemoglobin,HGB)、D-二聚体水平,下肢深静脉血栓(deep veinthrombosis,DVT)、低氧血症、卧床时间、肺源性心脏病、慢性阻塞性肺疾病(chronic obstructive pulmonary dis-ease,COPD)均是高原地区PTE发病的危险因素,组间比较差异具有统计学意义(P<0.05)。两组性别、年龄、职业差异无统计学意义(P>0.05)。多因素Logistic回归分析显示红细胞水平>5.5×1012/L、HGB水平>180g/L、DVT、D-二聚体>12000μg/L、卧床时间>3d是影响高原地区PTE发病的独立危险因素(OR=2.32~2.79,均P<0.05)。结论红细胞水平>5.5×1012/L、HGB水平>180g/L、D-二聚体>12000μg/L、卧床时间>3d、DVT均会增加高原地区PTE的患病风险,因此对于高危患者需要定期去医院检查并积极治疗相关疾病。

Objective To investigate the influencing factors of pulmonary arterial thrombosis（ PTE） in the plateau region.Methods 200 cases of PTE patients in our hospital were selected,100 patients living in high altitude area of 2500 ~ 4500 m were included into the observation group,and 100 patients in the low altitude area of 1500 ~ 2499 m were included into the control group. The basic demographic data in the two groups such as sex,age,ethnicity and so on were investigated. Routine examinations such as blood examination and medical history investigation were carried out. Single factor analysis was used to analyze the risk factors of the disease incidence in plateau area. Multivariate Logistic regression analysis was used to analyze to explore the independent risk factors. Results Single factor analysis showed that erythrocyte concentration,hemoglobin（ HGB）concentration,D-dimer concentration,deep vein thrombosis（ DVT）,hypoxemia,bedridden time,pulmonary heart disease,chronic obstructive pulmonary disease（ COPD） were the risk factors of PTE in the plateau region,and the difference was statistically significant（ P 0. 05）. There were no significant differences in gender,age and occupation between the two groups（ P 0. 05）. Multivariate logistic regression analysis showed that erythrocyte concentration 5. 5 × 1012/L,HGB concentration 180 g/L,DVT,D-dimer concentration 12,000μg/L,and the time of bedtime was 3 d,they were the independent risk factors of PTE in the plateau area（ OR = 2. 32 ~ 2. 79,P 0. 05）. Conclusions Erythrocyte concentration 5. 5 × 1012/L,HGB concentration 180 g/L,D-dimer concentration 12,000μg/L,the time of bedtime 3 d and DVT will increase the risks of PTE in the plateau area. Patients with high-risk need regular examinations and active treatments for related diseases.