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肿瘤患者与非肿瘤患者合并肺栓塞的临床分析

Clinical analysis of tumor and non-tumor patients complicated with pulmonary embolism.

作者信息

Wang Hong, Huang Yuan, Xu Chun-Wei, Lin Li

机构信息

Department of Cardiovascular Medicine, 307 Hospital of PLA Beijing 100071, People's Republic of China.

Department of Clinical Laboratory, 307 Hospital of PLA Beijing 100071, People's Republic of China.

出版信息

Int J Clin Exp Med. 2015 Oct 15;8(10):18729-36. eCollection 2015.

Abstract

OBJECTIVE

To analyze the differences of the clinical characteristics and risk factors between tumor and non-tumor patients complicated with pulmonary embolism.

METHODS

A retrospective analysis was conducted on 96 hospitalized patients complicated with pulmonary embolism admitted into 307 Hospital of PLA from January 2009 to December 2014. 96 cases were divided into tumor group (n=52) and non-tumor group (n=44) according to whether they were accompanied with malignant tumors. The relevant characteristics of tumor group, comparison of the risk factors and laboratory results between two groups were assessed.

RESULTS

Lung cancer was prone to pulmonary embolism in malignant tumors and adenocarcinoma was the commonest pathological type. 31 (59.6%) cases developed pulmonary embolism within 3 months after tumor was diagnosed. The level of serum D-dimer and leukemia in tumor group were higher than that in non-tumor group (3241.06±4514.16 μg/L vs 1238.49±1236.69 μg/L and 9.68±5.53×10(9)/L vs 7.90±3.84×10(9)/L), with a significant statistical difference (P=0.004 and 0.015). The level of serum platlet in tumor group were lower than that in non-tumor group (204.63±132.58×10(9)/L vs 222.26±76.92×10(9)/L), with a significant statistical difference (P=0.023). Coronary heart disease, chronic lung disease, diabetes, hyperlipemia and cerebral infarction were significantly different between two groups (P<0.01). Unexplained dyspnea (51/96, 53.1%) was the main symptom of pulmonary embolism, yet no significant difference was found between the two groups. 33 cases (34.4%) combined with deep venous thrombosis of lower limb, right lower limb more than the left. Right main pulmonary artery and its branches embolism were seen in 46 cases (47.9%) according to imaging examination, and no significant difference between two groups. After thrombolytic and anticoagulant therapy, only 9 cases died of Pulmonary embolism.

CONCLUSION

There is no obvious and significant difference in clinical symptoms between tumor and non-tumor patients complicated with pulmonary embolism. Using of anticoagulant and thrombolytic therapy can obtain good curative effect upon diagnosis.

摘要

目的

分析合并肺栓塞的肿瘤患者与非肿瘤患者临床特征及危险因素的差异。

方法

回顾性分析2009年1月至2014年12月解放军第307医院收治的96例合并肺栓塞的住院患者。根据是否伴有恶性肿瘤将96例患者分为肿瘤组(n = 52)和非肿瘤组(n = 44)。评估肿瘤组的相关特征、两组间危险因素及实验室检查结果的比较。

结果

恶性肿瘤中肺癌易发生肺栓塞,腺癌是最常见的病理类型。31例(59.6%)患者在肿瘤确诊后3个月内发生肺栓塞。肿瘤组血清D - 二聚体水平及白细胞计数高于非肿瘤组(3241.06±4514.16μg/L vs 1238.49±1236.69μg/L,9.68±5.53×10⁹/L vs 7.90±3.84×10⁹/L),差异有统计学意义(P = 0.004和0.015)。肿瘤组血清血小板水平低于非肿瘤组(204.63±132.58×10⁹/L vs 222.26±76.92×10⁹/L),差异有统计学意义(P = 0.023)。冠心病、慢性肺病、糖尿病、高脂血症及脑梗死在两组间差异有统计学意义(P < 0.01)。不明原因呼吸困难(51/96,53.1%)是肺栓塞的主要症状,但两组间无明显差异。33例(34.4%)合并下肢深静脉血栓形成,右侧下肢多于左侧。影像学检查显示46例(47.9%)为右主肺动脉及其分支栓塞,两组间无明显差异。经溶栓及抗凝治疗后,仅9例死于肺栓塞。

结论

合并肺栓塞的肿瘤患者与非肿瘤患者临床症状无明显显著差异。诊断后采用抗凝及溶栓治疗可取得良好疗效。

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