肺血栓栓塞症的危险因素

Risk Factors of Pulmonary Thromboembolism

目的:分析肺血栓栓塞症(PTE)患者的危险因素。方法:回顾性地分析121例符合PTE诊断标准的住院患者的临床资料,这些数据包括患者的危险因素、治疗及预后等。结果:121例患者中平均年龄(62.0±14.7)岁,其中老年组(≥60岁)73例(60.3%),非老年组(<60岁)48例(39.7%)。老年患者(≥60岁)、手术、恶性肿瘤是PTE常见的危险因素,老年组危险因素主要是恶性肿瘤、既往脑卒中等,非老年组为手术、骨折或大创伤,其差异均有统计学意义(P<0.05)。17例(14.0%)进行溶栓治疗,100例(82.6%)进行抗凝治疗,病死率为8.3%。中危PTE患者溶栓与抗凝治疗的有效率无显著性差别(P>0.05);溶栓治疗出血并发症为30%,高于抗凝组(5.5%,P<0.05)。结论:PTE常见的危险因素是年龄≥60岁、手术、恶性肿瘤等,老年组与非老年组危险因素有区别,中危PTE患者溶栓或抗凝治疗需结合临床具体分析。

Objective：To analyze the risk factors of patients diagnosed as pulmonary thromboembolism（PTE）.Methods：We retrospectively analyzed the data from 121 hospitalized patients with PTE.These data included risk factors,treatment and prognosis.Results：The mean age of patients with 121 PTE was（62.0±14.7）years;73subjects（60.3%）of patients were aged 60 years or older and 48（39.7%）were60years.Elderly patients（≥60years）,surgery and cancer were the major risk factors in the patients with PTE.Major risk factors for elderly acute PTE included cancers and previous stroke.Major risk factors for non-elderly PTE included surgery and fracture or major trauma（P〈0.05）.14.0%（17/121）and 82.6%（100/121）had received thrombolytic and anticoagulant therapy,respectively.The mortality rate of PTE was 8.3%.There was no significant difference in the effective rate between thrombolysis therapy and anticoagulant therapy for intermediate risk of acute pulmonary thromboembolism（P〉0.05）.The bleeding incidence rate was 30% in thrombolysis therapy and higher than that in anticoagulant therapy（5.5%,P〈0.05）.Conclusion：Elderly patients（≥60years）,surgery and and cancers was the major risk factor in the patients with PTE.There are differences in risk factors between elderly group and younger group.Thrombolytic or anticoagulant therapy for intermediate risk of acute pulmonarythromboembolism requires a combination of clinical manifestations.