临床肺科杂志
臨床肺科雜誌
림상폐과잡지
JOUNAL OF CLINICAL PULMONARY MEDICINE
2015年
2期
272-275
,共4页
急性肺栓塞%肺动脉高压%危险分层%预后评估
急性肺栓塞%肺動脈高壓%危險分層%預後評估
급성폐전새%폐동맥고압%위험분층%예후평고
acute pulmonary embolism%pulmonary hypertension%risk stratification%prognosis
目的：通过超声心动图对急性肺栓塞（APE ）患者肺动脉压力进行估测，探讨肺动脉高压在急性肺栓塞患者危险分层及预后评估中的价值。方法收集2010－2014年新疆医科大学第一附属医院确诊急性肺栓塞的患者77例进行回顾性分析，将其分为肺动脉高压组（＞30 mmHg）及肺动脉高压正常组（≤30 mmHg），其中肺动脉高压组40例，肺动脉压力正常组37例，对两组间危险因素、危险分层、临床表现、血生化指标、预后进行比较；结果肺动脉高压组与肺动脉压力正常组相比，年龄偏大，危险因素中基础疾病相对较多，P＜0.05；肺动脉高压与危险分层之间密切相关，P＜0.01；肺动脉高压的程度与肺栓塞面积相关，P＜0.05；肺动脉高压组比肺动脉压力正常组NT-proBNP及D－二聚体水平显著升高，P＜0.05，而PaO2和 PaCO2低于肺动脉压正常组，P＜0.05；心电图改变中肺动脉高压组出现T波倒置及右束支传导阻滞的发生率明显高于肺动脉压正常组，P＜0.05；肺动脉高压组不良事件的发生率以及临床症状中出现咯血、晕厥的概率明显高于肺动脉压正常组，P＜0.05；结论肺动脉高压在急性肺栓塞中与年龄、基础疾病、肺栓塞面积有关系，它在急性肺栓塞严重程度、危险分层及预后评估中有一定的价值，可以作为一项有意义的评估指标。
目的：通過超聲心動圖對急性肺栓塞（APE ）患者肺動脈壓力進行估測，探討肺動脈高壓在急性肺栓塞患者危險分層及預後評估中的價值。方法收集2010－2014年新疆醫科大學第一附屬醫院確診急性肺栓塞的患者77例進行迴顧性分析，將其分為肺動脈高壓組（＞30 mmHg）及肺動脈高壓正常組（≤30 mmHg），其中肺動脈高壓組40例，肺動脈壓力正常組37例，對兩組間危險因素、危險分層、臨床錶現、血生化指標、預後進行比較；結果肺動脈高壓組與肺動脈壓力正常組相比，年齡偏大，危險因素中基礎疾病相對較多，P＜0.05；肺動脈高壓與危險分層之間密切相關，P＜0.01；肺動脈高壓的程度與肺栓塞麵積相關，P＜0.05；肺動脈高壓組比肺動脈壓力正常組NT-proBNP及D－二聚體水平顯著升高，P＜0.05，而PaO2和 PaCO2低于肺動脈壓正常組，P＜0.05；心電圖改變中肺動脈高壓組齣現T波倒置及右束支傳導阻滯的髮生率明顯高于肺動脈壓正常組，P＜0.05；肺動脈高壓組不良事件的髮生率以及臨床癥狀中齣現咯血、暈厥的概率明顯高于肺動脈壓正常組，P＜0.05；結論肺動脈高壓在急性肺栓塞中與年齡、基礎疾病、肺栓塞麵積有關繫，它在急性肺栓塞嚴重程度、危險分層及預後評估中有一定的價值，可以作為一項有意義的評估指標。
목적：통과초성심동도대급성폐전새（APE ）환자폐동맥압력진행고측，탐토폐동맥고압재급성폐전새환자위험분층급예후평고중적개치。방법수집2010－2014년신강의과대학제일부속의원학진급성폐전새적환자77례진행회고성분석，장기분위폐동맥고압조（＞30 mmHg）급폐동맥고압정상조（≤30 mmHg），기중폐동맥고압조40례，폐동맥압력정상조37례，대량조간위험인소、위험분층、림상표현、혈생화지표、예후진행비교；결과폐동맥고압조여폐동맥압력정상조상비，년령편대，위험인소중기출질병상대교다，P＜0.05；폐동맥고압여위험분층지간밀절상관，P＜0.01；폐동맥고압적정도여폐전새면적상관，P＜0.05；폐동맥고압조비폐동맥압력정상조NT-proBNP급D－이취체수평현저승고，P＜0.05，이PaO2화 PaCO2저우폐동맥압정상조，P＜0.05；심전도개변중폐동맥고압조출현T파도치급우속지전도조체적발생솔명현고우폐동맥압정상조，P＜0.05；폐동맥고압조불량사건적발생솔이급림상증상중출현각혈、훈궐적개솔명현고우폐동맥압정상조，P＜0.05；결론폐동맥고압재급성폐전새중여년령、기출질병、폐전새면적유관계，타재급성폐전새엄중정도、위험분층급예후평고중유일정적개치，가이작위일항유의의적평고지표。
Objective To investigate the effect of pulmonary hypertension on the risk stratification and prog-nosis of acute pulmonary embolism.Methods The clinical data of 77 patients with acute pulmonary embolism were retrospectively analyzed.They were divided into the hypertension group (n=40)and the normal group (n=37)ac-cording to the limit of pulmonary artery pressure of 30mmHg.Their risk factors,risk stratification,clinical manifesta-tions,blood biochemistry and prognosis were compared.Results Compared with the normal group,the hyperten-sion group had older age and more basic diseases in risk factors (P<0.05).Pulmonary hypertension was closely as-sociated with risk stratification (P<0.01 ),and the degree of pulmonary hypertension was associated with pulmonary embolism area.The levels of NT-proBNP and D-dimer were significantly higher in the pulmonary hypertension group than in the normal group (P<0.05 ),but the levels of PaO2 and PaCO2 was lower in the pulmonary hypertension group than in the normal group (P<0.05).ECG changes in the pulmonary hypertension group had T-wave inversion and right bundle branch block,which was significantly higher than those in the normal group (P<0.05).The inci-dence of adverse events and appearance of hemoptysis,syncope probability of the clinical symptoms was significantly higher in the pulmonary hypertension group than in the normal group (P<0.05).Conclusion Pulmonary hyperten-sion may be related with age,underlying diseases and embolism area,and it has a certain value in the assessment of severity,risk stratification and prognosis of acute pulmonary embolism.
