摘要
目的探讨新冠疫情期间某三级综合医院住院急性肺栓塞(APE)入院患者的临床特征,并分析APE预后的危险因素。方法选择新冠疫情期间(2020年6月—2023年6月)在首都医科大学附属复兴医院住院的APE患者114例,收集患者的临床资料,采用单因素和多因素回归分析APE预后的危险因素。结果114例患者首发症状为呼吸困难43例、胸闷17例、咯血12例及胸痛10例等,合并症为脑血管疾病29例、肺部感染27例及恶性肿瘤20例等。114例患者住院期间死亡24例。单因素分析结果显示,年龄、制动时间>3 d、低氧血症、否合并下肢静脉血栓、是否合并肺动脉高压、是否右心室扩大、急性肺栓塞分级、Pudua评分、D-二聚体(D-D)、肌钙蛋白(TnT)及N末端B型钠尿肽前体(NT-proBNP)与APE的预后相关(r分别为-0.335、0.205、0.290、0.109、0.212、0.185、0.245、0.192、0.238、0.382、0.399,P均<0.05),性别、吸烟史、BMI、新冠病毒感染、近期手术和合并慢性病的数量与APE预后无关(r分别为-0.045、-0.036、-0.082、-0.045、0.0321、0.0361,P均>0.05)。多因素分析结果显示,高龄、制动时间>3 d、低氧血症、D-D和NT-proBNP是新冠期间APE患者死亡的危险因素(P均<0.05)。结论新冠疫情期间该三级综合医院住院APE患者常见首发症状是呼吸困难和胸闷,常合并脑血管病和肺部感染。APE死亡的危险因素有高龄、制动时间长及合并多种基础疾病等。
Objective To explore the clinical characteristics and prognostic risk factors of inpatients with acute pulmonary embolism(APE)admitted to a tertiary general hospital during the Corona Virus Disease 2019(COVID-19)period.Methods A total of 114 patients with APE at Fuxing Hospital of Capital Medical University during the COVID-19 period(June 2020-June 2023)were selected.The clinical data were collected.Univariate and multivariate regression analyses were conducted to identify the risk factors for the prognosis of APE.Results Among 114 patients,the initial symptoms included 43 cases of dyspnea,17 cases of chest tightness,12 cases of hemoptysis and 10 cases of chest pain,etc.There were 29 cases with cerebrovascular disease,27 cases with pulmonary infection and 20 cases with malignant tumor,etc.and 24 patients died during the study period.The univariate analysis results showed that age,immobilization time>3 days,hypoxemia,whether combined with lower extremity venous thrombosis,whether combined with pulmonary hypertension,whether right ventricular enlargement,acute pulmonary embolism grade,Pudua score,D-dimer(D-D),troponin T(TnT)and N-terminal pro-brain natriuretic peptide(NT-proBNP)were related to the prognosis of APE(r=-0.335,0.205,0.290,0.109,0.212,0.185,0.245,0.192,0.238,0.382,0.399,all P<0.05).Gender,smoking history,BMI,COVID-19 infection,recent surgery and the number of chronic diseases combined were not related to the prognosis of APE(r=-0.045,-0.036,-0.082,-0.045,0.0321,0.0361,all P>0.05).The multivariate analysis results showed that advanced age,immobilization time>3 days,hypoxemia,D-D and NT-proBNP were risk factors for death in APE patients during the COVID-19 period(all P<0.05).Conclusions During the COVID-19 period,the common initial symptoms of APE patients admitted to this tertiary general hospital were breathing difficulties and chest tightness.The common complications were cerebrovascular diseases and pulmonary infections.The risk factors for APE death were advanced age,long period of immobilization,and the presence of multiple underlying diseases.
作者
朱瑞霞
何耀红
陈谨
李宁
李倩
ZHU Ruixia;HE Yaohong;CHEN Jin;LI Ning;LI Qian(Department of Pulmonary and Critical Care Medicine,Fuxing Hospital,Capital Medical University,Beijing 100038,China)
出处
《山东医药》
2025年第9期76-79,84,共5页
Shandong Medical Journal
关键词
急性肺栓塞
呼吸困难
高龄
肺动脉高压
新冠疫情
acute pulmonary embolism
dyspnea
advanced age
pulmonary hypertension
COVID-19 pandemic
