摘要
目的对老年低危肺血栓栓塞(PTE)患者接受华法林单一抗凝治疗后消化道的有关比较及危险因素分析。方法初次诊断为PTE且年龄≥16岁的门诊及急诊患者530例,采取相同的治疗方法下,规律性随访观察3个月,记录消化道出血的总例数及每个月发生频数,根据患者年龄进行划分,可分为老年组(≥60岁)和非老年组(<60岁),比较两者之间诊断前的临床资料以及两种人群在出血在当中的差异。统计老年组低危PTE患者中按照消化道是否出血分为两类,得出相对危险因素,最后在这些相对危险因素中两两对比,得出老年特定患者的独立危险因素。结果老年组在年龄上与非老年组比较差异有统计学意义(t=35. 015,P <0. 01);老年组在高血压、心功能不全、糖尿病、脑血管病发生率较非老年组高(χ~2=5. 848、4. 516、5. 247、6. 573,P=0. 019、0. 034、0. 022、0. 010);老年组低危PTE患者在接受相同治疗后在消化道出血发生率显著高于非老年组(χ~2=13. 884,P <0. 01),而活动性肿瘤、慢性肝病、心功能不全、慢性阻塞性肺疾病,是消化道出血的独立危险因素(RR值=1. 322、2. 122、7. 252、2. 131,P值=0. 0353、0. 0052、0. 0073、0. 0044)。结论老年低危PTE患者较非老年患者发生率高,而老年PTE患者合并有慢性阻塞性肺疾病、慢性肝病、活动性肿瘤患者在接受单一华法林治疗后更易出现消化道出血。
Objective To investigate the incidences of clinical relevant bleeding events and risk factors in elderly patients with low risk pulmonary thromboembolism after warfarin single anticoagulation therapy.Methods A total of 530 patients(age≥16 years)who were firstly diagnosed as pulmonary thromboembolism(PTE)in our hospital from December 2013 to December 2015 including outpatient and emergency patients were enrolled in the study.Under the circumstance of the same therapy,these patients were followed up regularly for 3 months.According to patient’s age,these patients were divided into elderly group(≥60 years)and non-elderly group(<60 years),then the clinical data and incidence of bleeding were observed and compared between the two grousp.Moreover the related risk factors were observed and compared to get the independent risk factors of elderly patients with PTE.Results There was a significant difference in patient’s age between elderly group and non-elderly group(t=35.015,P<0.01).The incidence rates of hypertension,heart failure,diabetes mellitus and cerebrovascular disease in elderly group were significantly higher than those in non-elderly group(χ2=5.848,4.516,5.247,6.573,respectively,P<0.05).Moreover the incidence rate of gastrointestinal bleeding in patients with low-risk PTE in the elderly group was significantly higher than that in non-elderly group(χ2=13.884,P<0.01),moreover,active tumor,chronic liver disease,heart failure,chronic obstructive pulmonary disease were independent risk factors of gastrointestinal bleeding(RR=1.322,2.122,7.252,2.131,respectively,P<0.05 or P<0.01).Conclusion The incidence rate of PTE in elderly patients with low risk is higher than that in non elderly patients,moreover,the elderly patients with PTE complicated by chronic obstructive pulmonary disease,chronic liver disease,active cancer after single warfarin therapy are more easy to suffer from gastrointestinal bleeding.
作者
任景锋
李伟
王忠
刘丹丹
冯敏娟
REN Jingfeng;LI Wei;WANG Zhong;LIU Dandan;FENG Minjuan(Department of Respiratory Medicine,Xianyang Hospital Affiliated to Yan’an University,Shaanxi,Xianyang 712000,China)
出处
《河北医药》
CAS
2018年第21期3281-3284,共4页
Hebei Medical Journal
关键词
老年人
低危
肺血栓栓塞
消化道出血
the elderly
low risk
pulmonary embolism
alimentary tract hemorrhage
