中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

急性肺栓塞患者复发的危险因素分析

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目的 探究急性肺栓塞(APE)患者复发的独立危险预测因素。 方法 先后纳入 2014 年 1 月至 2015 年 12 月天津医科大学总医院呼吸与危重症医学科住院患者中首诊的 APE 患者 169 例,随访至初诊后 2 年(最终时间结点 2017 年 12 月)。回顾性分析患者病历资料并收集潜在危险因素,随访患者抗凝疗程及复查转归,计算复发率;根据是否复发分组,先进行单因素分析,再针对两组间有显著差异的危险因素进行多因素分析,最终得到与 APE 复发相关的独立危险预测因素。 结果 169 例 APE 患者在接受 2 年随访后,共 23 例复发,复发概率为 13.6%。单因素分析:严重肺部疾病、长期卧床、恶性肿瘤、免疫系统疾病、特发性肺栓塞、D-二聚体持续异常 6 项因素在复发组与非复发组之间的差异有统计学意义(P<0.05),即与 APE 复发相关;多因素回归分析:恶性肿瘤(OR=8.384,P=0.003)、免疫系统疾病(OR=5.353,P=0.038)、特发性肺栓塞(OR=10.609,P=0.001)为 APE 患者复发的独立危险因素。 结论 APE 患者有较高的栓塞复发率,恶性肿瘤、免疫系统疾病以及特发性肺栓塞是导致 APE 复发的独立危险因素。临床医师需要对此类患者进行定期的风险/获益评估后制定个体化的抗凝治疗方案。早期识别 APE 复发的独立危险因素对制定个体化的抗凝方案、改善患者的预后具有重要的临床指导意义。

关键词: 急性肺栓塞; 复发; 危险因素; 基础疾病

引用本文: 张鑫, 董丽霞, 曹洁, 韩雪娇. 急性肺栓塞患者复发的危险因素分析. 中国呼吸与危重监护杂志, 2018, 17(5): 514-517. doi: 10.7507/1671-6205.201801054 复制

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