Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, USA.
Best Pract Res Clin Haematol. 2012 Sep;25(3):235-42. doi: 10.1016/j.beha.2012.06.007. Epub 2012 Aug 9.
Pulmonary embolism is the third most common cardiovascular disease after myocardial infarction and stroke. The death rate from pulmonary embolism exceeds the death rate from myocardial infarction, because myocardial infarction is much easier to detect and to treat. Among survivors of pulmonary embolism, chronic thromboembolic pulmonary hypertension occurs in 2-4 of every 100 patients. Post-thrombotic syndrome of the legs, characterized by chronic venous insufficiency, occurs in up to half of patients who suffer deep vein thrombosis or pulmonary embolism. We have effective pharmacological regimens using fixed low dose unfractionated or low molecular weight heparin to prevent venous thromboembolism among hospitalized patients. There remains the problem of low rates of utilization of pharmacological prophylaxis. The biggest change in our understanding of the epidemiology of venous thromboembolism is that we now believe that deep vein thrombosis and pulmonary embolism share similar risk factors and pathophysiology with atherothrombosis and coronary artery disease.
肺栓塞是心肌梗死和中风之后的第三大常见心血管疾病。肺栓塞的死亡率超过心肌梗死，因为心肌梗死更容易被发现和治疗。在肺栓塞的幸存者中，慢性血栓栓塞性肺动脉高压每 100 例中就有 2-4 例。腿部血栓后综合征，其特征为慢性静脉功能不全，在深静脉血栓形成或肺栓塞患者中高达一半会发生。我们有有效的药物治疗方案，使用固定低剂量未分馏或低分子量肝素预防住院患者的静脉血栓栓塞。药物预防的利用率仍然很低。我们对静脉血栓栓塞的流行病学的理解发生的最大变化是，我们现在认为深静脉血栓形成和肺栓塞与动脉血栓形成和冠心病具有相似的危险因素和病理生理学。
