摘要
目的分析高原地区肺动脉血栓栓塞(pulmonary thromboembolism,PTE)的临床特点及相关危险因素,提高对高原地区PTE的认识。方法采用病例对照研究方法,选择居住地海拔2 500~4 500 m的54例PTE患者为高原组,选择同期在我院住院的居住地海拔1 800~2 450 m的36例PTE患者为对照组,回顾性分析2组患者的临床资料,统计PTE患者危险因素构成比,对PTE相关的基本资料、临床症状和体征、实验室辅助检查结果、危险因素进行单因素分析,筛选出有统计学意义的因素,进行多因素非条件Logistic回归分析。结果 54例高原地区PTE患者中,合并下肢深静脉血栓(deep vein thrombosis,DVT)40例,占74.1%,其中12例合并高原红细胞增多症,占22.2%;合并慢性阻塞性肺疾病(chronic obstructive pulmo-nary disease,COPD)9例,占16.7%,其中3例合并DVT,占5.6%;单纯肺栓塞合并高原红细胞增多症患者3例,占5.6%;冠心病合并高原红细胞增多症者继发肺栓塞1例,占1.9%;其他原因4例,占7.4%。单因素方差分析显示,高原组与对照组呼吸困难、胸痛、低氧血症、肺动脉高压、高原红细胞增多症、红细胞计数、血红蛋白(hemoglobin,HGB)浓度比较,差异有统计学意义(P<0.05)。多因素非条件Logistic回归方程分析显示,红细胞计数、HGB浓度增高为高原地区PTE的独立危险因素(OR值分别为13.624、10.680)。结论高原地区PTE患者呼吸困难、胸痛、低氧血症发性生率较低海拔地区高,红细胞增多、HGB浓度增高是独立危险因素。
Objective To analyze the clinical features and related risk factors of patients with pulmonary thromboembolism（ PTE） living in plateau area,for a better understanding of the incidence of highaltitude PTE. Methods By using case-control study method,54 patients with PTE living in the altitude of2 500 ～ 4 500 m and 36 patients with PTE living in the altitude of 1 800 ～ 2 450 m who were treated in our hospital during January 2013 and March 2016 were recruited and assigned into plateau group and control group. Clinical data of all patients were retrospectively analyzed. Results Among the 54 patients with PTE,40 cases（ 74. 1%） had deep vein thrombosis（ DVT）,of which 12 cases（ 22. 2%） were concurrent highaltitude polycythemia; 9 cases（ 16. 7%） had chronic obstructive pulmonary disease（ COPD） including3 cases（ 5. 6%） complicated by DVT; 3 cases（ 5. 6%） had pulmonary embolism accompanied with highaltitude polycythemia; 1 patient with coronary heart disease（ 1. 9%） had pulmonary embolism secondary to high-altitude polycythemia; 4 cases（ 7. 4%） occurred with other reasons. One-way analysis of variance（ ANOVA） showed that there were significant differences in the levels of dyspnea,chest pain,hypoxemia,pulmonary hypertension, high-altitude polycythemia, red blood cell count and hemoglobin（ HGB）concentration between the plateau and control groups（ P〈0. 05）. Multivariate non-conditional logistic regression analysis showed that the count of red blood cells and elevated HGB concentration were independent risk factors for PTE incidence in plateau areas（ OR = 13. 624,10. 680）. Conclusion PTE occurred in plateau area has its own characteristics,which is closely related to high-altitude polycythemia and elevated HGB concentration.
作者
曹成瑛
陈秋红
陈红
王生元
罗焕
Cao Chengyin Chen Qiuhong Chen Hong Wang Shengyuan Luo Huan(Department of Radiology, Qinghai Provincial Hospital of Cardiovascular and Cerebrovascular Diseases, Xining, Qihai Province, 810012, China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2017年第4期390-393,共4页
Journal of Third Military Medical University
关键词
高原地区
肺动脉
血栓
血红蛋白浓度
红细胞
plateau
pulmonary arteries
thrombosis
hemoglobin concentration
red blood cells
作者简介
[通信作者]陈秋红，E-mail：chqh666@aliyun．com
