Arribas J R, Arnalich F, García-Rodeja M E, Monereo A, Lahoz C, Gamallo C, Vázquez J J
Servicio de Medicina Interna, Hospital La Paz, Facultad de Medicina, Universidad Autónoma de Madrid.
Med Clin (Barc). 1990 Apr 14;94(14):525-7.
A series of 63 cases of fatal acute pulmonary thromboembolism (PTE) with available necropsy study was evaluated The diagnosis was established ante mortem in 20 cases (predictive index 31%). The diagnosis was only suspected in 2 of the 16 patients in whom PTE was associated with pneumonia (predictive index 12.5%, p less than 0.01), in 3 of the 26 cases if PTE associated with neoplasia (predictive index 11.5% p less than 0.01) and in 8 of the 41 cases with terminal disease (predictive index 19.5%, p less than 0.01). On the contrary, thrombophlebitis and relapsing PTE had a significative facilitation effect on the diagnosis (predictive indexes 53.3% and 52.6%, respectively; p less than 0.01). It was concluded that the presence of neoplasia, pneumonia or terminal illness make the diagnosis of pulmonary thromboembolism difficult.
对63例有尸检研究的致命性急性肺血栓栓塞症（PTE）病例进行了评估。生前确诊20例（预测指数31%）。在16例PTE合并肺炎的患者中，仅2例生前疑似诊断（预测指数12.5%，p<0.01）；在26例PTE合并肿瘤的病例中，3例生前疑似诊断（预测指数11.5%，p<0.01）；在41例终末期疾病患者中，8例生前疑似诊断（预测指数19.5%，p<0.01）。相反，血栓性静脉炎和复发性PTE对诊断有显著的促进作用（预测指数分别为53.3%和52.6%；p<0.01）。得出的结论是，肿瘤、肺炎或终末期疾病的存在使得肺血栓栓塞症的诊断困难。
