摘要
目的:探讨伴发晕厥的肺栓塞患者的临床相关危险因素。方法:共457例确诊肺栓塞患者纳入研究,分为晕厥组(44例)和无晕厥组(413例),采用非条件Logistic回归对两组患者的临床表现、实验室检查、体格检查和影像学特征进行危险因素的单因素和多因素分析。结果:(1)单因素分析:肺栓塞伴发晕厥的发生率为9.6%(44/457),其中年龄>60岁、有冠心病、高血压、脑卒中、下肢静脉血栓病史的肺栓塞患者发生晕厥的风险高。晕厥组中存在血压下降、胸痛及中心型肺栓塞的患者较无晕厥组比例增加,其简化的肺栓塞严重程度指数(s PESI)评分较无晕厥组升高;(2)多因素分析:多项变量进行Logistic回归分析得出:高血压、冠心病病史及中心型血栓是肺栓塞患者发生晕厥的独立危险因素。结论:既往有高血压、冠心病病史可能是肺栓塞发生晕厥的高危因素;伴有晕厥的肺栓塞患者多出现血压下降,多为中心型血栓栓塞。
Objective To investigate the risk factors of syncope symptom in patients with pulmonary embolism （PE）. Methods 457 patients with confirmed pulmonary embolism were recruited in the study. They were divided into two groups： the syncope group （44 patients） and the group without syncope （413 patients ）. The clinical manifestation, laboratory examination, physical examination, imagingof all patients were analyzed by unconditional logistic regression. Results （ 1 ）Single factor analysis,prevalence of syncope was 9.6% （44/457） in these patients with PE.Those with syncope had some higher risk factors, including age over 60, coronary heart disease, hypertension, stroke and lower limb vein thrombosis history. The proportion of failing pressure chest painand centricity thrombus in syncope group were increasing compared with the groupwithout syncope.Puhnonary embolism severity index （sPESI） score was higher than groupwithout syncope. （2） Multivariate analysis showed that hypertension coronary heart disease and Centricity thrombus were the independent correlates of the presence of syncope in the patients with PE. Conclusions Patients who had histories of hypertension and coronary heart disease may have the higher risk factors of syncope. Blood pressure falling and central localization may be more likely to happen in PE patients with syncope.
作者
和雪改
毛毅敏
何俊
HE Xuegai MAO Yimin HE Jun(The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China)
出处
《实用医学杂志》
CAS
北大核心
2017年第4期558-560,共3页
The Journal of Practical Medicine
基金
国家"十二五"科技支撑计划课题(编号:2011BAI11B17)
关键词
晕厥
肺栓塞
sPESI评分
中心型肺栓塞
Syncope symptom
Puhnonary embolism
SPESI score
Centraltype ofpuhnonary embolism
