老年肺动脉栓塞的临床和病理特点

The clinical and pathological characteristics of the elderly patients with pulmonary embolism

目的 :了解尸检证实的老年肺动脉栓塞 (PE)患者临床病理特点。方法 :回顾性分析我院近 2 0年尸检中确诊PE的 31例患者的临床病理资料 ,并将≥ 65岁 (A)组与 <65岁 (B)组PE患者特点进行比较。结果 :31例PE患者年龄 (57 3± 1 8 6)岁 ,≥ 50岁 2 0例 (64 5 % ) ,发病年龄高于以往文献。A组与B组比较 :①男性患者比率高 (80 0 %比 43 8% ,P <0 0 5) ;②基础疾病中心血管病比率高 (73 3 %比 1 8 8% ,P <0 0 0 5) ;③肺动脉血栓形成比率高 (5例均在A组 ) ;④栓子特点 :血栓的比率高 (93 3 %比 43 8% ,P <0 0 1 ) ,位于肺动脉主干和左右肺动脉的比率高 (73 3 %比 2 5 0 % ,P <0 0 5)。⑤临床表现 :呼吸困难突发或加剧的发生率高 (86 7%比 50 0 % ,P <0 0 5) ;⑥危险因素 :重病卧床者比率高 (66 7%比 31 3 % ,P <0 0 5) ;⑦PE误诊率在两组间无明显差异 (80 0 %比 81 3 % )。结论 :由于尸检资料证实 ,PE患者发病年龄增高 。

Objective:To elucidate the clinical and pathological characteristics of the elderly patients with pulmonary embolism(PE) proved by autopsy Methods: 31 PE patients were divided into two groups: group A (>=65 years) and group B(<65 years) Then their clinical and pathological data were compared Results: The mean ages was 57 3±18 6 20 patients were no less than 50 years old (64 5%) The age was higher than that of other reported Significant differences between group A and B were found in several aspects (1) The incidence of PE in male patients in group A is higher than that of in group B (80 0% to 43 8%), (2) the incidence of cardiovascular diseases is higher (73 3% to 18 8%) (3) The ratio of pulmonary thrombosis is higher (All 5 patients were in group A) (4) The ratio of thrombus is high in group A and the embolus often occurred in the main branch of pulmonary artery and the left or right PA (5) The ratio of dyspnea and sickbed patients was higher (86 7% to 50 0%, 66 7% to 31 3%) (6) There was no significant difference in the rate of misdiagnosis between the two groups (80 0% to 81 3%) Conclusion: We must pay attention to identify the clinical and pathological characteristics of the elderly patients, and to improve the ratio of clinical diagnosis because of the higher age of PE patients