急性肺栓塞合并2型糖尿病的临床特征分析

Clinical analysis of acute pulmonary embolism with type 2 diabetes mellitus

目的：探讨急性肺栓塞合并2型糖尿病患者的临床特征及复发率。方法回顾性分析2010年1月至2015年12月在首都医科大学良乡教学医院住院诊断为急性肺栓塞患者126例，其中合并2型糖尿病患者43例为观察组，其余83例为对照组，分析两组间临床表现、合并症、实验室检查结果、栓子部位、危险分层及肺栓塞复发率的不同。结果两组间年龄、性别及临床表现未见明显差异，观察组合并呼吸衰竭、冠心病及肺部感染较对照组明显增加（P〈0.05）；观察组肌酸激酶（CK）、乳酸脱氢酶（LDH）、空腹血糖（Glu）、全血肌钙蛋白I（cTnI）、N末端脑钠肽前体（NT-pro-BNP）、肌酐（CREA）均较对照组明显升高（P〈0.05）；观察组危险分层中高危患者较对照组多（P〈0.05）；观察组肺栓塞复发率较对照组高（P〈0.05）。结论急性肺栓塞合并2型糖尿病病情多较重，合并症多，易出现呼吸衰竭，复发率高，临床上应重视此类患者，严格控制危险因素，预防复发。

Objective To explore the clinical features and recurrence rates of acute pulmonary embolism （APE） with type 2 diabetes mellitus（DM2）. Methods 126 patients with acute pulmonary embolism were retrospectively analysed from January 2010 to December 2015. All patients were divided into two groups：observation group （APE with DM2,43 cases） and control group（APE without DM2,83 cases）.The differences of clinical manifestations, complications,laboratory results,thrombus localizations,risk stratification and the recurrence rates of acute pulmonary embolism were analysed between the two groups. Results There were no significant differences in age,sex and clinical manifestations between the two groups. The combination of respiratory failure,coronary heart disease and pneumonia were more frequently seen in observation group（P〈0.05）. The level of creatine kinase, lactate dehydrogenase, fasting blood glucose,cTnI,NT-pro-BNP, CREA were obviously higher than control group（P〈0.05）. A higher risk stratification and recurrence rate were observed in the bservation group（P〈0.05）. Conclusion Patients with acute pulmonary embolism and type 2 diabetes mellitus are more serious and more affected by complications and a higher recurrence rate,thus,we should give more attention to these patients and reduce the recurrence rate.