疑诊肺栓塞患者337例中合并下肢深静脉血栓的发生率

The prevalence of deep venous thrombosis in 337 suspected pulmonary embolism patients

目的评价疑诊肺栓塞患者中合并下肢深静脉血栓的发生率。方法顺序收集2004年1月至2006年6月在北京首都医科大学附属朝阳医院和宁夏医学院附属医院内疑诊肺栓塞的患者，进行CT肺动脉造影（CTPA）联合下肢CT静脉造影检查（CTV）或CTPA联合下肢静脉超声检查。分析肺栓塞患者中合并下肢深静脉血栓的发生率以及下肢深静脉血栓的发生部位有无不同。采用SPSS11．5统计软件进行数据分析，描述性结果采用频数分析法，组间比较采用卡方检验。结果共337例患者纳入研究，男189例，女148例，中位年龄62岁，范围19～84岁。CTPA诊断肺栓塞者144例，CTV和下肢超声检查诊断下肢深静脉血栓患者100例。肺栓塞患者合并下肢深静脉血栓的发生率为44％（63／144），其中76％（48／63）发生于近端深静脉内；而下肢深静脉血栓形成患者中合并肺栓塞的发生率为63％（63／100）。结论无论肺栓塞患者合并下肢深静脉血栓，还是下肢深静脉血栓患者合并肺栓塞的发生率均很高，有必要同时进行肺动脉和下肢深静脉检查。

Objective The purpose of our study was to evaluate the prevalence of deep venous thrombosis（DVT） in suspected pulmonary embolism patients. Methods From January 2004 to June 2006, all patients who underwent CT pulmonary angiography combined with lower extremity CT venography or lower extremity sonography were consecutively enrolled in 2 hospitals. The prevalence of deep venous thrombosis in suspected pulmonary embolism patients and the location of DVT were analyzed. The statistical analyses were performed with the SPSS 11.5 statistical software, frequency analysis was performed for discriptive results and ehi-square analysis was performed for comparison between groups. Results Three hundred and thirtyseven consecutive patients were enrolled. There were 189 men and 148 women. The median age was 62 （range from 19 to 84 years old）. Pulmonary embolism were diagnosed by CT pulmonary angiography in 144 patients, and DVT was diagnosed by CT venography or lower extremity sonography in 100 patients. The prevalence of DVT in pulmonary embolism patients was 44%, and 76% DVT was located in proximal lower extremity veins. The prevalence of pulmonary embolism in DVT patients was 63%. Conclusion The prevalence of DVT in patients with pulmonary embolism and the prevalence of pulmonary embolism in patients with DVT are both high（44% vs 63% ） ; therefore it is necessary to examine the pulmonary arteries and the lower extremity deep veins at the same time.