本文選題：肺血栓栓塞 + 危險(xiǎn)分層��； 參考：《中國(guó)全科醫(yī)學(xué)》2017年25期

【摘要】：目的探討肺血栓栓塞(PTE)患者危險(xiǎn)分層的影響因素以及不同危險(xiǎn)分層PTE患者的臨床表現(xiàn)及血脂水平,為臨床PTE危險(xiǎn)分層和制定合理治療方案提供依據(jù)。方法選取2010—2014年中國(guó)醫(yī)科大學(xué)附屬盛京醫(yī)院收治的PTE患者60例,依據(jù)2014年歐洲心臟病學(xué)會(huì)(ESC)制定的《急性肺栓塞診斷及管理指南》中提出的PTE的危險(xiǎn)分層標(biāo)準(zhǔn),將納入患者分為高/中危組(n=35)和低危組(n=25)。收集兩組患者的臨床資料,比較兩組患者的基本情況、臨床表現(xiàn)及血脂水平,采用多因素Logistic回歸分析探討PTE危險(xiǎn)分層的影響因素。結(jié)果兩組患者年齡比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);男性比例及吸煙、飲酒、高血壓、冠心病、糖尿病、腦血管疾病、下肢深靜脈血栓(DVT)、近期手術(shù)、創(chuàng)傷、長(zhǎng)期臥床史比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。年齡是PTE危險(xiǎn)分層的影響因素[OR=1.145,95%CI(1.059,1.238),P0.05]。兩組心悸、咯血或痰中帶血、暈厥、瀕死感發(fā)生率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);呼吸困難、咳嗽、胸痛、三聯(lián)征發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組心動(dòng)過(guò)速、頸靜脈充盈發(fā)生率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);下肢腫脹、體溫升高、呼吸急促、濕Up音、發(fā)紺、第二心音亢進(jìn)、哮鳴音發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者血清總膽固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、載脂蛋白AⅠ、載脂蛋白B水平比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論高齡是發(fā)生高/中危PTE的危險(xiǎn)因素。若PTE患者存在心悸、暈厥、瀕死感、心動(dòng)過(guò)速及頸靜脈充盈等臨床癥狀及體征,臨床中需要警惕高/中危PTE的發(fā)生。
[Abstract]:Objective to investigate the influencing factors of risk stratification in patients with pulmonary thromboembolism (PTE) and the clinical manifestations and blood lipid levels of patients with PTE with different risk stratification, so as to provide evidence for clinical risk stratification of PTE and rational treatment plan. Methods A total of 60 patients with PTE were selected from Shengjing Hospital affiliated to China Medical University from 2010 to 2014. According to the risk stratification criteria for acute pulmonary embolism (PTE) developed by the European Society of Cardiology in 2014, the guidelines for diagnosis and Management of Acute Pulmonary embolism (APE) were used. The patients were divided into high / moderate risk group (n = 35) and low risk group (n = 25). The clinical data of the two groups were collected, and the basic condition, clinical manifestation and blood lipid level of the two groups were compared. The risk factors of PTE risk stratification were analyzed by multivariate Logistic regression analysis. Results there were significant differences in age between the two groups (P 0.05), smoking, drinking, high blood pressure, coronary heart disease, diabetes, cerebrovascular disease, DVT, recent operation, trauma, long-term bed rest history. The difference was not statistically significant (P 0.05). Age was the influencing factor of PTE risk stratification. The incidence of palpitation, hemoptysis or sputum with blood, syncope and near-death were significantly different between the two groups (P 0.05), but the incidence of dyspnea, cough, chest pain and triple sign were not significantly different (P 0.05). There was no significant difference in the incidence of tachycardia and jugular vein filling between the two groups (P 0.05), swelling of lower limbs, elevation of body temperature, shortness of breath, wet up, cyanosis, hyperactivity of the second cardiac sound and wheezing. There was no significant difference in serum total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apolipoprotein A 鈪，

本文編號(hào)：1778394