摘要
目的:分析结缔组织病(CTD)合并肺血栓栓塞(PTE)患者的临床特征。方法:回顾性分析2006—2015年广西医科大学第一附属医院收治的17例CTD合并PTE患者的临床资料。结果:17例患者中,男7例,女10例,年龄15~72岁,平均(40±16)岁。按PTE危险度分为低危组12例,中危组3例,高危组2例。确诊为系统性红斑狼疮9例,系统性血管炎2例,贝赫切特综合征2例,未分化CTD、皮肌炎、抗J0-1抗体综合征及抗磷脂抗体综合征各1例。主要表现为呼吸困难、胸痛、咯血、发热等。5例动脉氧分压(PaO_2)<10.6kPa。自身抗体阳性13例,红细胞沉降率(ESR)(54.50±29.61)mm/h。D-二聚体定量167~4 173μg/L。合并肺实质或间质病变13例,肺动脉瘤2例。同时合并下腔静脉、门静脉等栓塞。16例予糖皮质激素、免疫抑制剂,联合溶栓或抗凝治疗,抗凝时间为4~23个月,预后良好。结论:CTD作为PTE危险因素,临床中易造成CTD的漏诊及误诊。重视CTD的治疗有利于PTE患者好转及减少栓塞复发。
Objective：To analyze the clinical features and treatment of 17 cases of connective tissue disease （CTD） complicated with pulmonary thromboembolism （PTE）. Methods. The clinical data of 17 patients with CTD and PTE treated in our hospital from 2006 to 2015 were retrospectively analyzed. Results. Of 17 cases, 7 were male and 10 were female. The age ranged from 15 to 72 years with an average age of （40± 16） years. There were 12 cases of low-risk, 3 cases of intermediate risk and 2 cases of high-risk according to PTE risk degree. 9 cases were diagnosed as systemic lupus erythematosus, 2 cases were systemic vasculitis, 2 cases were Behcet＇s syndrome, 1 case was undifferentiated connective tissue disease, 1 case was der- matomyositis, 1 case was anti J0-1 antibody syndrome and 1 case was antiphospholipid syndrome. The main symptoms were dyspnea, chest pain, hernoptysis, cough and fever. The arterial oxygen partial pressure （PaO2） was lower than 10.6 kPa in 5 cases. Positive autoantibody was found in 13 cases, and the elevated erythrocyte sedimentation rate （ESR） in 14 cases and elevated C-reactive protein in 11 cases. The D- dimer level in 17 cases were 167μg/L to 4,173 μg/L. 13 cases were complicated with pulmonary parenchyma or interstitial lesion, and 2 cases of pulmonary artery aneurysm. And some of them had inferior vena cava, portal vein thrombosis. 16 cases were treated with glucocorticoid and immunosuppressive agents combined with thrombolytic therapy. The anticoagulant period ranged from 4 months to 23 months. Conclusion. As one of the risk factors for pulmonary embolism, CTD was easy to miss diagnose or misdiagnose in PTE patients. Paying attention to the treatment of CTD could promote the recovery of PTE and reduce recurrence.
出处
《广西医科大学学报》
CAS
2017年第5期714-717,共4页
Journal of Guangxi Medical University
基金
国家自然科学基金资助项目(No.81460009)
关键词
结缔组织病
肺血栓栓塞
临床特征
connective tissue disease
pulmonary thromboembolism
clinical features
