肺血栓栓塞症患者易栓症的分析研究

Thrombophilia analysis in patients with pulmonary thromboembolism

目的:探讨我国肺血栓栓塞症(PTE)患者易栓症的发生率,以提高临床PTE的诊断与预防复发的水平。方法:自2004年2月至2009年12月,连续观察我院呼吸科、急诊呼吸监护室确诊的PTE患者123例,其中男性60例,女性63例,并对其遗传性和获得性易栓症进行回顾性分析,得出所有患者遗传性和获得性易栓症的发生率,并比较性别对抗凝蛋白缺陷的影响。结果:123例PTE患者中获得性易栓症中长期制动、静脉曲张/血栓性静脉炎及手术/创伤居前3位,其发生率分别为14.6%、12.2%及8.1%。遗传性易栓症总的发生率为:55.3%,其中发生率较高的是:蛋白S(PS)缺陷17.1%,PC缺陷10.5%,蛋白C(PC)、PS联合缺陷12.2%。抗凝蛋白缺陷男女均为34例,性别间差异无统计学意义(P>0.05)。抗凝蛋白缺陷率性别间差异无统计学意义。结论:PTE患者中易栓症的发生率较高,PTE可能是遗传性和获得性易栓症共同作用的结果。

Objective：To investigate the incidences of thrombophilia in pulmonary thromboembolism（PTE） in Chinese population,and to improve the diagnosis of PTE and decrease the recurrence rate of PTE.Methods：From February 2004 to December 2009,consecutive 123 PTE patients（60 male,63 female） in respiratory department and emergency intensive care unit in Beijing Anzhen Hospital were enrolled in our study.Both inherited and acquired thrombophilia were well retrospectively studied.The incidence of inherited and acquired thrombophilia in the 123 PTE patients was analysed,and the incidence of inherited thrombophilia between two sex was also compared.Results：Immobilization,varicosity/thrombophlebitis,operation/trauma were more common acquired thrombophilia.The incidences were 14.6%,12.2%,8.1%,respectively.The total incidence of anticoagulant protein deficiency was 55.3%,in which Single protein S deficiency,combined protein C and protein S deficiency,single protein C deficiency was more common inherited thrombophilia,and the incidence was 17.1%,12.2%,10.5% separately.The male and female PTE patients with anticoagulant protein deficiency were all 34 cases,and there was no significant difference between two sex（P 0.05）.Conclusion：The incidence of thrombophilia in PTE patients may be higher than that we used to think.Both inherited and acquired thrombophilia may be contribute to the development of pulmonary thromboembolism.There is no significant difference in anticoagulant protein deficiency between two sex.