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肺栓塞患者的临床症状及相关危险因素和基于这些症状的聚类分析。

Clinical symptoms and related risk factors in pulmonary embolism patients and cluster analysis based on these symptoms.

机构信息

Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China.

Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China.

出版信息

Sci Rep. 2017 Nov 2;7(1):14887. doi: 10.1038/s41598-017-14888-7.

Abstract

Pulmonary embolism (PE) remains largely underdiagnosed due to nonspecific symptoms. This study aims to evaluate typical symptoms of PE patients, their related predictors, and to differentiate typical clusters of patients and principal components of PE symptoms. Clinical data from a total of 551 PE patients between January 2012 and April 2016 were retrospectively reviewed. PE was diagnosed according to the European Society of Cardiology Guidelines. Logistic regression models, system clustering method, and principal component analysis were used to identify potential risk factors, different clusters of the patients, and principal components of PE symptoms. The most common symptoms of PE were dyspnea, cough, and tachypnea in more than 60% of patients. Some combined chronic conditions, laboratory and clinical indicators were found to be related to these clinical symptoms. Our study also suggested that PE is associated with a broad list of symptoms and some PE patients might share similar symptoms, and some PE symptoms were usually cooccurrence. Based on ten symptoms generated from our sample, we classified the patients into five clusters which represent five groups of PE patients during clinical practice, and identified four principal components of PE symptoms. These findings will improve our understanding of clinical symptoms and their potential combinations which are helpful for clinical diagnosis of PE.

摘要

肺栓塞(PE)由于其非特异性症状,在很大程度上仍未得到充分诊断。本研究旨在评估 PE 患者的典型症状、相关预测因素,并对 PE 症状的典型聚类和主要成分进行区分。回顾性分析了 2012 年 1 月至 2016 年 4 月间共 551 例 PE 患者的临床资料。PE 的诊断依据欧洲心脏病学会指南。采用逻辑回归模型、系统聚类法和主成分分析法,识别潜在的危险因素、患者的不同聚类以及 PE 症状的主要成分。PE 最常见的症状是呼吸困难、咳嗽和呼吸急促,超过 60%的患者有这些症状。一些合并的慢性疾病和实验室及临床指标与这些临床症状有关。我们的研究还表明,PE 与一系列广泛的症状有关,一些 PE 患者可能具有相似的症状,一些 PE 症状通常同时出现。基于我们样本中的十个症状,我们将患者分为五个聚类,代表临床实践中五个不同的 PE 患者群体,并确定了 PE 症状的四个主要成分。这些发现将提高我们对临床症状及其潜在组合的理解,有助于 PE 的临床诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a01/5668424/d84ec8d1c412/41598_2017_14888_Fig1_HTML.jpg

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