CAJ | 학술논문

目的探讨糖尿病(DM)并发肺血栓栓塞症(PE)的相关危险因素.方法对58例DM行双下肢99 mTc-MAA深静脉显像(和/或超声检查)、肺灌注显像,同期获取空腹血糖、血胆固醇、血甘油三酯等实验室资料及年龄、病程、胸部症状(胸痛和呼吸困难)、下肢症状(肿胀、静脉曲张和DM足)、急性并发症(酮症酸中毒和高渗性昏迷)等临床资料.利用SPSS进行Logistic回归分析和χ2检验.结果 28例DM(48.3%)并发下肢深静脉血栓(DVT),10例(17.2%)并发PE,有DVT的DM的PE发病率(32.1%)明显高于无DVT的DM(3.3%)(χ2=6.53,P＜0.05).单因素分析发现胸部症状、下肢症状、急性并发症3因素各自的PE发病率差异均有统计学意义(均P＜0.05),而年龄、病程、血糖、血胆固醇、血酯、血压、体重指数、糖尿病类型等因素各自PE发病率元明显差异(均P＞0.05).多因素分析提示PE危险因素包括胸部症状(Score=13.316,P＜0.01)和下肢症状(Score=7.780,P＜0.01),而其他因素的危险度均无统计学意义(均P＞0.05).结论对有胸部症状、下肢症状和/或下肢DVT的重症DM患者应尽早干预治疗,以减少PE发生.
목적 탐토당뇨병(DM)병발폐혈전전새증(PE)적상관위험인소.방법 대58례DM행쌍하지99 mTc-MAA심정맥현상(화/혹초성검사)、폐관주현상,동기획취공복혈당、혈담고순、혈감유삼지등실험실자료급년령、병정、흉부증상(흉통화호흡곤난)、하지증상(종창、정맥곡장화DM족)、급성병발증(동증산중독화고삼성혼미)등림상자료.이용SPSS진행Logistic회귀분석화χ2검험.결과 28례DM(48.3%)병발하지심정맥혈전(DVT),10례(17.2%)병발PE,유DVT적DM적PE발병솔(32.1%)명현고우무DVT적DM(3.3%)(χ2=6.53,P＜0.05).단인소분석발현흉부증상、하지증상、급성병발증3인소각자적PE발병솔차이균유통계학의의(균P＜0.05),이년령、병정、혈당、혈담고순、혈지、혈압、체중지수、당뇨병류형등인소각자PE발병솔원명현차이(균P＞0.05).다인소분석제시PE위험인소포괄흉부증상(Score=13.316,P＜0.01)화하지증상(Score=7.780,P＜0.01),이기타인소적위험도균무통계학의의(균P＞0.05).결론 대유흉부증상、하지증상화/혹하지DVT적중증DM환자응진조간예치료,이감소PE발생.
Objective To study the related risk factors of pulmonary embolism(PE) in diabetic patients.Methods 58 diabetic cases were underwent lower limbs 99mTc-MAA veins imaging(and/or ultrasonography) and pulmonary perfusion imaging.The related laboratory data [fasting blood glucose(FBG),blood cholesterol,blood long chain triglycerides(LCT)]and clinial informations [age,disease courses,chest symptoms(chest pain and short of breathe),lower limbs symptoms(swelling,crooted veins and diabetic foot) and acute complication(diabetic ketoacidosis and hyperosmolar non ketotic diabetic coma)]were collected simultaneously.SPSS was used for χ2-test and Logistic regression analysis.Results 28 patients(48.3%) were showed to be with lower limbs deep vein thrombosis (DVT) and by 99Tcm-MAA imaging,10 cases(17.2%) with PE.The PE ratio(32.1%) of the patients with DVT was more higher than no DVT(3.3%)(χ2 = 6.53,P＜0.05).Single factor analysis showed the PE ratios had significant difference to factors of chest symptoms,lower limbs symptoms and acute complication(all P＜0.05),respectively.There were no significant difference in other factors of age,disease courses,FBG,blood cholesterol,LCT,blood pressure,weight index,DM type(all P＞0.05),respectively.Multiplicity analysis indicated:the related risk factors of PE included chest symptoms(Score = 13.316,P＜0.01) and lower limbs symptoms(Score = 7.780,P＜0.01).There were no significant differences in other factors(all P＞0.05),respectively.Conclusion The serious DM with chest symptoms,lower limbs symptoms and/or DVT could be controlled as early as possible by all kinds of treatment.It would decrease the PE complication.