早期诊断对老年肺栓塞患者的临床价值

Clinical value of early diagnosis in elderly patients with pulmonary embolism

目的探讨早期诊断对老年肺栓塞患者的临床价值。方法选取老年肺栓塞患者115例设为A组,另选取同期检查的非老年肺栓塞患者115例设为B组。A组患者年龄≥60周岁,男56例、女59例;B组患者年龄<60周岁,男57例、女58例。结果A组的男性(48.70%)、女性(51.30%)比例与B组的男性(49.57%)、女性(50.43%)比例无显著差异(P>0.05);A组患者年龄(74.31±1.23)岁、30d内病死率(21.74%)、30d后病死率(42.61%)、溶栓治疗率(9.57%)显著高于B组的年龄(50.38±1.08)岁、30d内病死率(10.43%)、30d后病死率(13.91%)、溶栓治疗率(3.49%)(P<0.05);A组患者的合并肿瘤发生率(11.30%)与B组患者的合并肿瘤发生率(12.17%)无显著差异(P>0.05);A组患者的心律失常(31.30%)、肺炎(33.91%)、心功能不全(36.52%)、慢性阻塞性肺病(26.96%)、肾功能不全(37.39%)、高血压病(65.21%)、低蛋白血症(18.26%)、糖尿病(32.17%)、高血脂症(16.52%)的发生率均显著高于B组患者的心律失常(17.39%)、肺炎(1.74%)、心功能不全(5.22%)、慢性阻塞性肺病(1.74%)、肾功能不全(0.87%)、高血压病(27.83%)、低蛋白血症(1.74%)、糖尿病(5.22%)、高血脂症(2.61%)的发生率(P<0.05);A组患者血压、脉博、心肌肌钙蛋白Ⅰ、血尿酸水平均显著高于B组,动脉血氧饱和度显著低于B组(P<0.05);A组D-二聚体(5.89±1.23)mg/L、血清白蛋白(24.13±0.23)g/L与B组D-二聚体(4.03±0.41)mg/L、血清白蛋白(24.09±0.01)g/L比较,差异无统计学意义(P>0.05)。结论早期诊断对老年肺栓塞患者的临床治疗具有较高的价值,通过早期诊断进行高危风险指标的确定,可为及时采取治疗措施提供参考依据。

Objective To investigate the clinical value of early diagnosis in elderly patients with pulmonary embolism.Methods A total of 115 elderly patients with pulmonary embolism who were examined in our hospital were selected as group A,and another 115 non-elderly patients with pulmonary embolism who were examined at the same period were selected as group B.Among them,there were 56 males and 59 females in group A,aged 60 years and above,57 males and 58 females in group B,aged below 60 years.Results There was no significant difference in the ratio of male to female in group A(48.70%vs.51.30%) and group B(49.57%vs.50.43%)( P >0.05).The age,mortality within 30 days,mortality after 30 days,and rate of thrombolytic therapy were (74.31± 1.23) years,21.74%,42.61%,9.57%,respectively,in group A,which were significantly higher than (50.38±1.08) years,10.43%,13.91%and 3.49%,respectively,in the group B( P < 0.05).There was no significant difference in the incidence of complicating with tumors between group A (11.30%) and group B (12.17%)( P >0.05).The incidences of arrhythmia,pneumonia,cardiac insufficiency,chronic obstructive pulmonary disease,renal insufficiency,hypertension,hypoproteinemia,diabetes and hyperlipidemiain were 31.30%,33.91%,36.52%,26.96%,37.39%, 65.21%,18.26%,32.17%,16.52%,respectively,in the group A,which were higher than 17.39%, 1.74%,5.22%,1.74%,0.87%,27.83%,1.74%,5.22%,2.61%,respectively,in group B( P <0.05)The blood pressure,pulse wave,cardiac troponin I and serum uric acid in group A were significantly higher,and arterial oxygen saturation was significantly lower than that in the control group ( P <0.05).The levels of D-dimer,and serum albumin were (5.89±1.23) mg/L,(24.13±0.23) g/L,respectively,in group A,and were (4.03±0.41) mg/L and (24.09± 0.01) g/L,respectively,in group B,which showed no significant differences between two groups.Conclusion Early diagnosis is of high clinical value for elderly patients with pulmonary embolism.The high-risk indicators of early diagnosis can be reference for timely treatment.