超声心动图在识别急性肺栓塞后有症状性综合征及其危险因素中的应用

Application of Echocardiography in Identifying Symptomatic Syndromesand Their Risk Factors after Acute Pulmonary Embolism

目的:通过为期1年的超声心动图随访研究,明确急性肺栓塞患者随访期间有症状性综合征的发生率,并分析其危险因素。方法:前瞻性选取2020年6月至2022年6月医院112例急性肺栓塞患者为研究对象,对所有患者进行为期1年的随访,采用超声心动图对有症状的患者进行右心导管评估,观察所有患者急性肺栓塞后有症状性综合征发生状况,并将其分为发生组与未发生组,对比两组临床资料,分析急性肺栓塞后有症状性综合征发生的危险因素。结果:随访1年,经超声心动图检查发现,112例急性肺栓塞患者中发生有症状性综合征71例,占63.39%;发生组恶性肿瘤、近期接受外科手术、制动、心血管疾病占比高于未发生组,D-二聚体水平高于未发生组(χ^(2)=5.986、5.889、6.008、6.690,t=4.394,均P<0.05);经Logistic回归分析结果显示,恶性肿瘤、近期接受外科手术、制动、心血管疾病、高D-二聚体水平是急性肺栓塞后有症状性综合征发生的危险因素(OR=8.966、3.885、5.673、9.825、9.644,P<0.05)。结论:急性肺栓塞后有症状性综合征发生率为63.39%,恶性肿瘤、近期接受外科手术、制动、心血管疾病、高D-二聚体水平是急性肺栓塞后有症状性综合征发生的危险因素(OR=8.966、3.885、5.673、9.825、9.644,P<0.05),临床应针对上述因素采取对应干预措施,以减少急性肺栓塞后有症状性综合征的发生。

Objective:Through a one-year follow-up study of echocardiography,the incidence of symptomatic syndrome in patients with acute pulmonary embolism during the follow-up period was determined,and the risk factors were analyzed.Methods:A prospective study was conducted on 112 patients with acute pulmonary embolism in hospitals from June 2020 to June 2022.All patients were followed up for a period of 1 year,and symptomatic patients were evaluated by right heart catheterization using echocardiography.The incidence of symptomatic syndrome after acute pulmonary embolism was observed in all patients,and they were divided into an occurring group and a non occurring group.Clinical data of the two groups were compared to analyze the risk factors for symptomatic syndrome after acute pulmonary embolism. Results:After a one-year follow-up period, echocardiography revealed that 71 out of 112 patients (63.39%) developed symptomatic syndrome. The proportion of malignant tumors, recent surgical intervention, immobilization, and cardiovascular diseases in the occurrence group was higher than that in the non occurrence group, and the D-dimer level was higher than that in the non occurrence group ( χ^(2)=5.986, 5.889, 6.008, 6.690, t =4.394, P <0.05). The results of Logistic regression analysis showed that malignant tumors, recent surgical intervention, immobilization, cardiovascular disease, and high D-dimer levels were risk factors for the occurrence of symptomatic syndrome after acute pulmonary embolism (OR=8.966, 3.885, 5.673, 9.825, 9.644, P <0.05). Conclusion:The incidence of symptomatic syndrome after acute pulmonary embolism is 63.39%. Malignant tumors, recent surgical intervention, immobilization, cardiovascular disease, and high D-dimer levels are risk factors for the occurrence of symptomatic syndrome after acute pulmonary embolism (OR=8.966, 3.885, 5.673, 9.825, 9.644, P <0.05). Corresponding intervention measures should be taken in clinical practice to reduce the occurrence of symptomatic syndrome after acute pulmonary embolism.