藏族靜脈血栓栓塞癥患者31例臨床分析_《中國呼吸與危重監護雜志》

作者：

四川大學華西醫院呼吸科(四川成都 610041);

關鍵詞：

深靜脈血栓肺栓塞藏族

DOI：

10.7507/1671-6205.2014047

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目的通過分析高原居住的藏族靜脈血栓栓塞癥(VTE)患者的臨床資料,了解藏族VTE患者的危險因素、發病特點以及預后情況。方法納入2010年1月至2012年12月四川大學華西醫院經CTPA或血管彩超檢查明確診斷的DVT或PE的長期高原居住的VTE藏族患者,回顧性調查患者的VTE危險因素,分析其臨床癥狀、體征及實驗室檢查結果,并電話隨訪。結果 31例VTE患者中男16例,女15例;危險因素分析顯示15例患者(48.3%)有肥胖體質,10例患者(32.3%)有高粘血癥。常見臨床癥狀依次為呼吸困難9例(29%),胸痛6例(19.4%),咯血5例(16.1%)和咳嗽咳痰4例(12.9%)。常見體征為下肢水腫22例(73.3%)和肺部啰音11例(36.7%)。所有患者均接受了抗凝治療,其中2例給予安置下腔靜脈濾器治療。出院后2年隨訪結果顯示31例患者中有4例患者死亡,2例死于腫瘤,2例死于PE;6例DVT病員出現患側下肢間斷性水腫、疼痛,1例出現肺栓塞后肺動脈高壓,20例患者血栓消失或機化再通,且未再出現VTE復發。結論藏族患者長期居住高海拔地區,且飲食習慣多為高脂飲食,增加了高粘血癥及肥胖等VTE獲得性危險因素。藏族VTE患者的臨床癥狀及體征無特異性,呼吸困難是最常見癥狀,下肢水腫為最常見體征。危險因素短期內可消除的VTE患者預后較好。

引用本文： 李華偉, 周海霞, 申永春, 易群, 楊婧, 王博, 王笑晴. 藏族靜脈血栓栓塞癥患者31例臨床分析. 中國呼吸與危重監護雜志, 2013, 12(2): 198-202. doi: 10.7507/1671-6205.2014047 復制

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8.	Braekkan SK,Mathiesen EB,Njølstad I,et al.Hematocrit and risk of venous thromboembolism in a general population.The Tromso study.Haematologica,2010,95:270-275.
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11.	朱鐵楠.D-二聚體檢測在靜脈血栓栓塞性疾病診治中的應用.中華內科雜志,2012,51:240-242.
12.	張蔚,梁瑛,楊京華,等.心電圖評分在急性肺血栓栓塞癥嚴重程度評估中的應用.臨床肺科雜志,2009,14:580-583.
13.	Koitabashi N,Toyama T,Hoshizaki H,et al.Electrocardiographic findings in pulmonary thromboembolism--comparison with lung perfusion scan and echocardiographic findings.Kaku Igaku,2000,37:645-651.
14.	Moya A,Sutton R,Ammirati F,et al.Guidelines for the diagnosis and management of syncope (version 2009).Eur Heart J,2009,30:2631-2671.

1. Schulman S.Advances in the management of venous thromboembolism.Best Pract Res Clin Haematol,2012,25:361-377.
2. Wolfe TR.Allen TL.Syncope as an emergency department presentation of pulmonary embolism.J Emerg Med,1998,16:27-31.
3. Anderson FA Jr,Spencer FA.Risk factors for venous thromboembolism.Circulation,2003,107(23 Suppl 1):I9-I16.
4. Allman-Farinelli MA.Obesity and venous thrombosis: a review.Semin Thromb Hemost,2011,37:903-907.
5. Zhou HX,Peng LQ,Yan Y,et al.Validation of the Caprini risk assessment model in Chinese hospitalized patients with venous thromboembolism.Thromb Res,2012,130:735-740.
6. Holst AG,Jensen G,Prescott E.Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study.Circulation,2010,121:1896-1903.
7. 王倫.四川高原藏區成人血常規正常參考值范圍調查.中華檢驗醫學雜志,2006,29:501.
8. Braekkan SK,Mathiesen EB,Njølstad I,et al.Hematocrit and risk of venous thromboembolism in a general population.The Tromso study.Haematologica,2010,95:270-275.
9. Arcelus JI,Caprini JA,Monreal M,et al.The management and outcome of acute venous thromboembolism: a prospective registry including 4011 patients.J Vasc Surg,2003,38:916-922.
10. 陳起航.CT肺動脈造影在肺栓塞診斷中的應用評價.中華醫學雜志,2012,92:1810-1812.
11. 朱鐵楠.D-二聚體檢測在靜脈血栓栓塞性疾病診治中的應用.中華內科雜志,2012,51:240-242.
12. 張蔚,梁瑛,楊京華,等.心電圖評分在急性肺血栓栓塞癥嚴重程度評估中的應用.臨床肺科雜志,2009,14:580-583.
13. Koitabashi N,Toyama T,Hoshizaki H,et al.Electrocardiographic findings in pulmonary thromboembolism--comparison with lung perfusion scan and echocardiographic findings.Kaku Igaku,2000,37:645-651.
14. Moya A,Sutton R,Ammirati F,et al.Guidelines for the diagnosis and management of syncope (version 2009).Eur Heart J,2009,30:2631-2671.

《中國呼吸與危重監護雜志》

藏族靜脈血栓栓塞癥患者31例臨床分析

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《中國呼吸與危重監護雜志》

藏族靜脈血栓栓塞癥患者31例臨床分析

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