不同年龄阶段肺血栓栓塞症患者临床特征对比分析

Differences in Clinical Features of Thromboembolism Between Older and Younger Patients

目的探讨不同年龄阶段肺血栓栓塞(pulmonary thromboembolism,PTE)患者的临床差异,提高对各年龄阶段PTE的认识。方法对海珠区第一人民医院和广州医学院第一附属医院2009至2011年确诊的198例PTE病例的资料进行回顾性分析。老年患者(≥60岁)105例,平均年龄(70.6±7.8)岁;非老年患者(<60岁)93例,平均年龄(43.6±7.5)岁。对比分析两年龄段PTE的临床特征。结果肺栓塞的常见症状有呼吸困难、咳嗽、心悸、胸痛、咯血、晕厥等;其中,非老年患者(<60岁)更易出现胸痛、咳血、三联征(即同时具有呼吸困难,胸痛,咳血症状);晕厥、肺部湿啰音、下肢静脉曲张更易出现于老年患者(≥60岁)。结论 PTE患者的临床表现多样,非老年患者PTE临床常见表现为胸痛、咳血、三联征,而老年患者随着年龄的增长,危险因素也增加,临床表现更加复杂多变,更容易出现晕厥、肺部湿啰音、下肢静脉曲张。

Objective To explore the difference of clinical features of pulmonary thromboembolism （PTE） between older and younger patients, in order to improve the diagnosis of PTE. Methods The clinical data of 198 patients with pulmonary thromboembolism in the first people＇s hospital of Haizhu district in Guangzhou and the first affiliated hospital of Guangzhou medical college from 2011 to 2012 were analyzed retrospectively, including 105 cases of elderly patients （age 1〉60 years old, average age of 70.6 _＋ 7.8）, and 93 cases of non-elderly patients （age 〈60 years, average age of 43.6 ＋ 7.5）. The clinical features of PET between elderly patients and non-elderly patients were compared. Results The main manifestations included dyspnea, cough, palpitation, chest pain, hemoptysis and syncope. Chest pain and hemoptysis were less frequent in older patients whereas syncope pulmonary tales, varicose veins of lower extremity occurred more often in the older group. Triplicate symptoms （including dyspnea, chest pain and hemoptysis） occurred more often in the younger group. Conclusions The clinical features of pulmonary thromboembolism （PTE） are different. Triplicate symptoms occur more often in the younger group, and the clinical features of elderly patients are complex, and risk factors also increases with the growth of the age; syncope pulmonary tales, varicose veins of lower extremity occur more often in the older group.