急性肺栓塞患者肺动脉压影响因素相关性分析

Correlation Analysis of Influencing Factors of Pulmonary Arterial Pressure in Patients with Acute Pulmonary Embolism

目的对比急性肺栓塞患者并发肺动脉高压与无肺动脉高压患者的临床资料差异性,分析急性肺栓塞患者肺动脉压影响因素及相关性。方法收集自2017年6月至2020年6月就诊于本院的住院急性肺栓塞患者,共计65例,入院患者均经超声心动图测定肺动脉收缩压(PASP),根据肺动脉收缩压分为两组,PASP>35 mmHg为肺动脉高压组(31例),PASP≤35 mmHg为无肺动脉高压组(34例)。对比两组间一般资料、影像学检查、实验室检查的差异并进行相关性分析。结果与无肺动脉高压组相比,肺动脉高压组D-二聚体、肌钙蛋白T、NT-proBNP及住院费用更高,PaO_(2)减低更显著,肺动脉高压组患者血栓更容易累及肺动脉主干;进一步行相关性分析提示肺动脉收缩压与NT-ProBNP呈正相关(r=0.626),与PaO_(2)呈负相关(r=-0.411)。结论急性肺栓塞是一种高致残率、高致死率的常见疾病,是住院患者非预期死亡的重要原因,并发肺动脉高压时增加病死率和住院费用,因此,做到早期识别与诊断,及时有效的救治,可改善预后。

Objective The influence and correlation of pulmonary hypertension of patients with acute pulmonary embolism are analyzed by comparing the clinical data of patients with acute pulmonary embolism with or without pulmonary hypertension.Methods The patients with acute pulmonary embolism admitted in the Inner Mongolia autonomous region people's hospital were collected from June 2017 to June 2020.A total of 65 cases were enrolled for retrospective study and divided into two groups according to the pulmonary artery systolic pressure(PASP)measured by echocardiography.Patients with PASP>35mmHg were in the pulmonary hypertension group(n=31),while patients with PASP≤35mmHg were in the non-pulmonary hypertension group(n=34).The differences in general data,imaging examinations,and laboratory examinations between the two groups was studied for correlation analysis.Results Compared with the non-pulmonary hypertension group,the pulmonary hypertension group had a higher value of D-dimer,troponin T,NT-proBNP and hospitalization costs but PaO2 was lower.The pulmonary hypertension group was more likely to involve thrombosis in the main pulmonary artery(P<0.05).Pulmonary artery systolic pressure was positively correlated with NT-ProBNP(r=0.626),and negatively correlated with PaO_(2)(r=-0.411).Conclusion Acute pulmonary embolism is a common disease with higher disability and mortality.It is an important cause of unexpected deaths in hospitalized patients.When pulmonary hypertension is complicated,the mortality rate and hospitalization costs increase significantly.Effective treatment in early stage of disease can improve the prognosis.