肺血栓栓塞症患者栓塞面积和临床特征的相关性分析

目的:分析肺血栓栓塞症患者栓塞面积和临床特征的相关性。方法:将哈尔滨医科大学附属第二医院呼吸内科2007年1月-2011年12月收治的78例肺血栓栓塞症患者作为研究对象,并根据其栓塞面积分为大面积组(38例)和小面积组(40例),观察和比较两组患者的临床症状、临床体征、危险因素分布、血气分析结果、D-二聚体水平。结果:大面积组呼吸困难、心悸、晕厥的发生率均显著高于小面积组,呼吸急促、发绀的发生率均明显高于小面积组患者,Pa O2和Pa CO2均显著低于小面积组,差异均具有统计学意义(P0.05)。半定量乳胶聚集法测定的D-二聚体值在两组之间未见明显统计学差异,免疫比浊法测定的D-二聚体值在大面积组明显高于小面积组,且具有统计学差(P0.05)。结论:(1)呼吸困难、晕厥、心悸、呼吸急促、血压下降、发绀可提示大面积肺血栓栓塞症的发生;(2)Pa O2和Pa CO2明显减低提示大面积肺栓塞可能性较大;(3)D-二聚体是否能提示肺栓塞面积大小可能与其测量方法有关,需进一步研究,但对排除肺栓塞有重要意义。

Analysis of the Correlation of Pulmonary Thromboembolism Area with Clinical Characteristics

Objective:To analyze the correlation of pulmonary thromboembolism area with clinical characteristics.Methods:78 patients with pulmonary thromboembolism who were treated in the respiratory medicine of the Second Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were taken as the research object. According to the embolization area, the paitients were divided into large embolization group (38 cases) and small embolization group (40 cases). Then the clinical symptoms, clinical signs, risk factors, blood gas analysis results and the two D-dimer level of patients in the two groups were observed and analyzed.Results:Dyspnea, palpitations, syncope in the large area group has a significantly higher incidence than in small area group, the incidence of shortness of breath, cyanosis were significantly higher than those in patients with small area group, PaO2 and PaCO2 were significantly lower than those in small area group, The difference was statistically significant (P<0.05). There is no significant difference in D-dimer values of two groups, which to be measured with Semi quantitative latex aggregation method. The D-dimer values in large area group, which to be measured with turbidmetric method, are significantly higher than that in small area group , and there is statistical difference (P<0.05).Conclusion:(1) The dyspnea, palpitations, syncope, shortness of breath, blood pressure drops, and cyanosis can prompt a massive pulmonary thromboembolism occurred.(2) The values of PaO2 and PaCO2, which are low significantly, suggesting that it may be is a large area of pulmonary embolism. (3) D- dimer could prompt pulmonary embolism size or not, may be related to the measurement method of D- dimer, which need further study, but there is an important significance for Excluding Pulmonary embolism.