摘要
目的:研究急性肺血栓栓塞症(PTE)伴发晕厥时的临床及影像学特点,并评价其治疗转归。方法:516例急性PTE患者,按照是否伴发晕厥分为2组,记录治疗前及治疗后14d的症状、体征,并进行心脏超声、核素肺灌注显像和(或)CT肺动脉造影检查,在治疗后14d进行临床疗效评价。结果:516例急性PTE患者中有67例出现晕厥,发生率13.0%。PTE伴晕厥者以大面积和次大面积PTE为主,心悸的发生率高于无晕厥者(P<0.001),低血压或休克、P2亢进和发绀的发生率明显高于无晕厥者(P<0.01);右心室功能不良在PTE伴晕厥者中多于无晕厥者(69.6%vs40.4%,P<0.001),核素肺灌注显像7个以上肺段受累者(73.3%)多于无晕厥者(48.1%);CT肺动脉造影(CTPA)显示,PTE伴晕厥者有94.7%累及中央肺动脉,而无晕厥者有74.3%累及中央肺动脉(P=0.001);治疗后14d,PTE伴晕厥者死亡4例(6.1%),明显高于无晕厥者(P=0.002)。结论:PTE伴晕厥者多有血流动力学异常或右心功能障碍,肺血管堵塞面积较大,容易发生病情恶化。
Objective：To evaluate the clinical and imaging characteristics and outcome of acute pulmonary thromboembolism （PTE） with syncope. Method：516 acute PTE patients were divided in two groups： 67 patients with syncope and 449 patients without syncope. The symptoms and signs were recorded and ultrasoundcardiogram and lung perfusion scan and/or CT angiography were performed before and after 14d treatment. Result： Patients with syncope had significant reductions in blood pressure and showed a more pronounced tendency to present with right ventricular dysfunction than patients without syncope （P 〈 0.01 and P 〈 0.001 ,respectively）. Cynosis and S2P increased were prominent in patients with syncope, and there were more main pulmonary artery embolus in patients with syncope than without syncope （ P = 0.001 ）. The mortality was higher in patient with syncope than without syncope （ P = 0.002）. Conclusion：Hemodynamic unstable and right ventricular dysfunction are seen frequently in patients with syncope, and major area of embolism are commonly, the course may be deteriorated in patient with syncope.
出处
《心肺血管病杂志》
CAS
2007年第1期3-6,共4页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家"十五"科技攻关课题资助项目(2004BA703B07)
关键词
急性肺血栓栓塞症
血栓
晕厥
Pulmonary thromboembolism
Thromboembolism
Syncope
