血清同型半胱氨酸和急性肺栓塞患者死亡的关系

Relationship Between Serum Homocysteine and Death in Patients with Acute Pulmonary Embolism

目的:探讨血清同型半胱氨酸(Hcy)水平与急性肺栓塞患者发生死亡的关系。方法:回顾性分析2009年8月至2012年8月期间于我院收治的200例急性肺栓塞患者的临床与检验资料,并根据血清Hcy水平分为105例高Hcy水平组(Hcy≥15.31μmol/L)与95例低Hcy水平组(Hcy<15.31μmol/L)。对比两组患者的基线特征,并采用Cox比例危险模型对Hcy水平与急性肺栓塞患者发生死亡的关系进行判断。结果:在随访期间内,共40例(20.00%)患者发生死亡,高Hcy水平组患者的死亡率为30.48%,显著高于低Hcy水平组的8.42%,且两组患者在入院时的氧饱和度、心率、收缩压、年龄、肌酐水平、肌钙蛋白T峰值、深静脉血栓史等对比,差异均存在统计学意义(P<0.05);经单因素筛选及多因素分析后,Hcy≥15.31μmol/L、深静脉血栓以及心率等均是影响患者发生死亡的独立危险因素(P<0.05)。结论:高血清Hcy水平与急性肺栓塞患者发生死亡具有显著相关性,可作为预测该疾病患者死亡的独立因子,应引起临床重视。

Objective：To explore the relationship between the level of serum homocysteine（Hcy）and death in patients with acute pulmonary embolism.Methods：The clinical and test data of 200 patients with acute pulmonary embolism in our hospital from August 2009 to August 2012 were analyzed retrospectively,and all of the patients were divided into 105 cases of high Hcy group（Hcy≥15.31μmol/L）and 95 cases of low Hcy group（Hcy15.31μmol/L）according to the level of serum Hcy.The patients＇ baseline characteristics of two groups were compared,and the relationship between the level of serum Hcy and death in patients with acute pulmonary embolism was judged by Cox proportional hazard model.Results：During the follow-up period,a total of 40（20.00%）patients died,the mortality rate of high Hcy group was 30.48%,which was significantly higher than 8.42% of low Hcy group,and the the differences in oxygen saturation,heart rate and systolic blood pressure,age,creatinine level,peak TnT level and history of deep venousthrombosis between the two groups were all statistical significant（P0.05）.After single factor screening and multi-factor analysis,Hcy acuity≥15.31μmol/L,deep vein thrombosis and higher heart rate were the independent risk factors of death in patients（P0.05）.Conclusion：High serum Hcy level is closely associated with the death in patients with acute pulmonary embolism,it can be used as predicting the independent factors of death in patients with the disease,which should be paid attention during clinical practice.