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肺栓塞患者肺梗死的临床意义。

Clinical relevance of pulmonary infarction in patients with pulmonary embolism.

机构信息

Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

出版信息

Thromb Res. 2012 Sep;130(3):e1-5. doi: 10.1016/j.thromres.2012.03.012. Epub 2012 Apr 4.

Abstract

INTRODUCTION

Data regarding the clinical relevance of pulmonary infarction (PI) in patients with pulmonary embolism (PE) are lacking. The aim of this study was to investigate the clinical features of PE patients with PI and the prognostic role of PI for PE patients.

MATERIALS AND METHODS

Based on computed tomography scan, 509 patients with PE were divided into two groups, the infarction group (n=45) and the non-infarction group (n=464). A variety of clinical parameters were compared between the two groups.

RESULTS

In the infarction group, the largest pulmonary arteries involved by emboli were central rather than peripheral and more proximal as compared to the non-infarction group (p=0.01 and p<0.03, respectively). Thrombolytic agents tended to be more frequently administered in the infarction group (13.3% [n=6] versus 6.3% [n=29], p=0.07). In-hospital mortality, PE-related deaths, and the recurrence rate of PE did not differ between the two groups.

CONCLUSIONS

The present study did not demonstrate that PI is a prognostic indicator of recurrence and mortality in PE patients. We suggest the possibility that blood clot burden is greater in PE patients with PI, although PI by itself occurs in small pulmonary arteries.

摘要

简介

关于肺栓塞(PE)患者肺梗死(PI)的临床相关性的数据尚缺乏。本研究旨在探讨伴有 PI 的 PE 患者的临床特征,以及 PI 对 PE 患者的预后作用。

材料与方法

根据计算机断层扫描,将 509 例 PE 患者分为两组,即梗死组(n=45)和非梗死组(n=464)。比较两组间的各种临床参数。

结果

在梗死组中,受累的最大肺动脉为中央型而非外周型,且更靠近近端,而非梗死组中则为外周型和更靠近远端(p=0.01 和 p<0.03)。梗死组更倾向于使用溶栓药物(13.3%[n=6]比 6.3%[n=29],p=0.07)。两组间院内死亡率、PE 相关死亡率和 PE 复发率无差异。

结论

本研究并未表明 PI 是 PE 患者复发和死亡的预后指标。我们推测,尽管 PI 本身发生在小肺动脉中,但 PI 的患者的血栓负荷可能更大。

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