摘要
目的探讨高原肺动脉血栓栓塞(PTE)的流行病学特征,增强人们对高原PTE的认知水平。方法选择2017年5月至2019年10月入青海省中医院的诊疗的286例PTE患者,根据海拔高低分为两组,其中研究组(143例)为居住在2500~4500m高海拔地区,对照组(143例)为居住在1500~2450m低海拔地区。比较两组的临床资料、D-D、FIB水平以及实验室常规检查,采用单因素分析其危险因素,多因素logistic回归分析其独立危险因素。结果两组患者的一般资料(性别、年龄)等差异无统计学意义(P>0.05)。参比对照组,研究组D-D、FIB水平均明显增加(P<0.05);单因素分析结果表明,高原红细胞增多症、血红蛋白、低氧血症、肺动脉高压、D-D水平,FIB水平、合并下肢深静脉血栓、肺源性心脏病、呼吸困难、胸痛均是高原地区PTE发病的危险因素;多因素logistic回归分析表明红细胞计数、HGB水平、血红蛋白浓度增高、DVT、D-D水平是影响高原地区PTE发病的独立危险因素。结论多因素logistic回归分析表明,红细胞水平、HGB水平、DVT、D-D、FIB是影响高原地区PTE发病的独立危险因素。血浆D-D、FIB水平是越高,复发间隔时间,尤其是高原患者的相关疾病,需要定期监测。
Objective The epidemiological characteristics of high-altitude pulmonary thromboembolism(PTE)were investigated,and to enhance people′s cognitive level of high-altitude PTE.Methods A tatal of 286 patients with PTE admitted to our hospital from May 2017 to October 2019 were selected and divided into study group(n=143)living at high altitude of 2500~4500 m and control group(n=143)living at low altitude of 1500~2450 m according to altitude.The clinical data,D-D,FIB levels,and laboratory routine examinations were compared between the two groups,and the risk factors were analyzed using univariate analysis and the independent risk factors were analyzed by multivariate logistic regression.Results The levels of D-D and FIB in the control group were significantly increased(P<0.05).Univariate analysis showed that high altitude polycythemia,hemoglobin,hypoxemia,pulmonary hypertension,D-D level,FIB level,lower extremity deep venous thrombosis,pulmonary heart disease,dyspnea and chest pain were all risk factors of PTE at high altitude.Multivariate logistic regression analysis showed that red blood cell count,HGB level,increased hemoglobin concentration,DVT and D-D level were independent risk factors of PTE at high altitude.There was no significant difference in the general data(gender,age,occupation)between the two groups(P>0.05).Conclusion Those were independent risk factors affecting the incidence of PTE at high altitude,including multivariate logistic regression analysis indicated that red blood cell level,HGB level,DVT,D-D,and FIB.The higher the plasma D-D and FIB levels,the recurrence interval,especially the related diseases of patients at high altitude need regular monitoring.
作者
祁耀宇
喇登海
孙嫣婷
QI Yaoyu;LA Denghai;SUN Yanting(Department of Pulmonary Disease,Qinghai Provincial Hospital of Traditional Chinese Medicine,Xining 810000,China;Department of Nephrology,Qinghai Provincial Hospital of Traditional Chinese Medicine,Xining 810000,China;Department of Cardiology,Qinghai Provincial Hospital of Traditional Chinese Medicine,Xining 810000,China)
出处
《公共卫生与预防医学》
2021年第5期145-148,共4页
Journal of Public Health and Preventive Medicine
