Department of Respiratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China.
Department of Respiratory Medicine, Central Hospital of ZiBo, Zibo, 255000, China.
J Thromb Thrombolysis. 2018 Jan;45(1):27-35. doi: 10.1007/s11239-017-1561-6.
The present study aimed to investigate the factors associating with the presence of residual thrombosis in patients with acute pulmonary embolism (APE) after at least 3-month anticoagulant therapy. Demographic and clinical data of 180 cases in the affiliated hospital of Qingdao University from January 2005 to June 2015 were retrospectively analyzed. APE in all patients were confirmed by computed tomography pulmonary angiography (CTPA). Patients were then detected for the presence of residual thrombosis according to a second CTPA. After appropriate comparison test, multivariate logistic regression analysis was performed to identify predictors for residual thrombosis. Among 180 patients, complete clearance of thrombosis occurred in 115 (63.9%) patients. Residual thrombosis remained in 65 (36.1%) patients. The independent factors associating with residual thrombosis include unprovoked APE (OR 0.231, 95% CI 0.062-0.861) and fibrinogen level in acute phase (OR 1.958, 95% CI 1.282-2.911). Furthermore, these two variables were both associated with the presence of residual thrombosis in patients receiving different parenteral anticoagulants (unfractionated heparin or low-molecular-weight heparin). Pulmonary thrombosis in some patients with APE are not completely dissolved after at least 3-month treatment. Additionally, unprovoked APE is positive predictor of decreased residual thrombosis and fibrinogen level in acute phase is a risk factor of the presence of residual thrombosis.
本研究旨在探讨急性肺栓塞（APE）患者抗凝治疗至少 3 个月后仍存在血栓的相关因素。回顾性分析 2005 年 1 月至 2015 年 6 月青岛大学附属医院收治的 180 例患者的临床资料。所有患者均经计算机断层扫描肺动脉造影（CTPA）确诊。根据第二次 CTPA 检测患者是否存在残余血栓。经适当比较检验后，采用多因素 logistic 回归分析确定残余血栓的预测因子。180 例患者中，115 例（63.9%）患者血栓完全清除，65 例（36.1%）患者仍存在残余血栓。与残余血栓相关的独立因素包括特发性 APE（OR 0.231，95%CI 0.062-0.861）和急性期纤维蛋白原水平（OR 1.958，95%CI 1.282-2.911）。此外，这两个变量均与接受不同的静脉抗凝剂（普通肝素或低分子肝素）治疗的患者存在残余血栓有关。APE 患者的部分血栓在至少 3 个月的治疗后并未完全溶解。此外，特发性 APE 是残余血栓减少的阳性预测因子，急性期纤维蛋白原水平是存在残余血栓的危险因素。
