不同部位急性肺栓塞的相关因素差异性分析及预后研究

Difference Analysis and Prognosis Study on the Related Factors of Acute Pulmonary Thromboembolism in Different Parts

摘要: 目的：探究不同部位急性肺栓塞的临床相关因素，并进行差异性分析及预后研究。方法：纳入2012年6月~2019年6月青岛大学附属医院诊治的急性肺血栓栓塞症患者995例，根据CTPA中肺栓子位置，分为中央型肺栓塞(394例)、肺叶及叶间动脉栓塞(352例)、周围型肺栓塞(249例) 3组，比较不同位置肺栓塞在临床症状、危险因素、实验室结果、预后等方面的差异。结果：在D-二聚体、高敏肌钙蛋白I、N末端BNP前体方面中央型明显高于周围型肺栓塞，而氧分压明显低于周围型肺栓塞，存在显著差异(p < 0.05)；中央型肺栓塞患者30天全因死亡率及肺栓塞相关死亡率均明显高于周围型肺栓塞患者(p < 0.05)。结论：周围型肺栓塞与其他2组肺栓塞相比较，临床症状轻微，血气分析结果较好，心肌损伤较小，30天死亡率低。

Abstract: Objective: To investigate the clinically relevant factors of acute pulmonary thromboembolism in different parts, as well as the difference analysis and prognosis study was conducted. Methods: From June 2012 to June 2019, a total of 995 patients with acute pulmonary thromboembolism di-agnosed and treated in the Affiliated Hospital of Qingdao University were included. According to the position of pulmonary embolism in CTPA, they were divided into central pulmonary embolism (394 cases), pulmonary lobe and interlobe arterial embolism (352 cases) and peripheral pulmonary embolism (249 cases) in three groups, for which the clinical symptoms, risk factors, laboratory results, and prognosis of pulmonary embolism in different locations were compared. Results: The D-dimer, high-sensitivity troponin I, and N-terminal BNP precursors in the central type were significantly higher than in peripheral pulmonary embolism, while the partial oxygen pressure was significantly lower than in peripheral pulmonary embolism, with significant differences (p < 0.05). The 30-day all-cause mortality and pulmonary embolism-related mortality in patients with central pulmonary embolism were significantly higher than in patients with peripheral pulmonary embolism (p < 0.05). Conclusion: Compared with the other two groups of pulmonary embolism, peripheral pulmonary embolism has mild clinical symptoms, better blood gas analysis results, less myocardial damage, and lower 30-day mortality.