韩涛 蔡恒烈

【摘要】 目的：分析急性肺栓塞（APE）患者的臨床特点及疾病发生的危险因素。方法：收集2017年

2月-2021年6月本院接收的发生APE的57例内科住院患者临床资料，将其纳入发生组，另收集同期本院接收的未发生APE的57例内科住院患者临床资料，将其纳入未发生组。查阅并记录患者相关资料，分析发生组患者的临床特点，并比较发生组与未发生组患者相关资料，分析APE发生的危险因素。结果：57例APE患者临床症状多样，其中以呼吸困难、胸膜性胸痛及咳嗽为主要症状，分别占50.88%、38.60%、22.81%;发生组卧床/制动时间≥7 d、合并恶性肿瘤占比、血清同型半胱氨酸（Hcy）、脂肪细胞因子13（Apelin-13）水平均高于未发生组，差异均有统计学意义（P<0.05）;经logistic回归分析，结果显示，卧床/制动时间≥7 d、合并恶性肿瘤、血清Hcy及Apelin-13过表达均为APE发生的危险因素（OR>1，P<0.05）。结论：APE患者多存在呼吸困难、胸膜性胸痛及咳嗽症状，且卧床/制动时间≥7 d、合并恶性肿瘤、血清Hcy及Apelin-13过表达均为APE发生的危险因素。

【关键词】 急性肺栓塞 胸痛 同型半胱氨酸 肿瘤

Analysis of Clinical Characteristics and Risk Factors of Patients with Acute Pulmonary Embolism/HAN Tao， CAI Henglie. //Medical Innovation of China， 2021， 18（34）： -118

[Abstract] Objective： To explore the clinical characteristics of patients with acute pulmonary embolism （APE） and the risk factors leading to the occurrence of the disease. Method： For retrospective analysis， the clinical data of 57 medical inpatients with APE received in our hospital from February 2017 to June 2021 were collected and included in the occurrence group， and the clinical data of 57 medical inpatients without APE received in our hospital during the same period were collected and included in the non-occurring group. The relevant data of patients were checked and recorded， the clinical characteristics of patients in the occurrence group were analyzed， the relevant data of patients in the occurrence group and the non-occurrence group were compared， and the risk factors for the occurrence of APE were analyzed. Result： The clinical symptoms of APE patients were diverse， among them， dyspnea， pleural chest pain and cough were the main symptoms， which accounted for 50.88%， 38.60%， and 22.81% respectively. The rates of bed/immobilization time ≥7 d and combined with malignant tumors， serum homocysteine （Hcy） and adipocytokine 13 （Apelin-13） levels in the occurrence group were higher than those in the non-occurrence group， and the differences were statistically significant （P<0.05）. logistic regression analysis showed Bed rest/immobilization time ≥7 d， malignant tumors， serum Hcy and Apelin-13 overexpression were all risk factors for APE （OR>1， P<0.05）. Conclusion： Most patients with APE have dyspnea， pleural chest pain and coughing symptoms， and bed/immobilization time ≥7 d， combined with malignant tumors， serum Hcy and Apelin-13 overexpression are all risk factors for APE.

[Key words] Acute pulmonary embolism Chest pain Homocysteine Tumor

First-author’s address： Pingxiang People’s Hospital， Pingxiang 337000， China

doi：10.3969/j.issn.1674-4985.2021.34.027

急性肺栓塞（acute pulmonary embolism，APE）是临床常见危重症之一，该病病情凶险、病情进展快、病死率较高，若未及时治疗，随着肺栓塞面积的不断扩大，可引发休克、右心室衰竭甚至死亡等严重后果，威胁患者生命安全[1]。但APE患者临床表现不典型，可能会导致误诊、漏诊等，延误治疗时间，增加患者病死风险[2]。因此，积极分析APE患者的临床特点及疾病发生的危险因素对提高诊断准确度及治疗方案的制定具有重要意义。本研究主要分析APE患者的临床特点及疾病发生的危险因素。……