Wu Jialin, Han Xiaobo, Ke Haiwen, Wang Li, Wang Kun, Zhang Jianli, Tang Jun, Yan Wei, Wang Guangjun, Jiang Peng
Department of Respiratory Disease, General Hospital of Xinjiang Military Command, Urumqi, China.
Department of Emergency, General Hospital of Xinjiang Military Command, Urumqi, China.
High Alt Med Biol. 2022 Sep;23(3):209-214. doi: 10.1089/ham.2021.0109. Epub 2022 May 23.
Wu, Jialin, Xiaobo Han, Haiwen Ke, Li Wang, Kun Wang, Jianli Zhang, Jun Tang, Wei Yan, Guangjun Wang, and Peng Jiang. Pulmonary embolism at extreme high altitude: A study of seven cases. 23:209-214, 2022. The incidence of venous thromboembolism (VTE) is high in high-altitude (HA) areas. We analyzed cases of pulmonary embolism (PE) in extreme HA areas to explore the epidemiological characteristics and risk factors of PE in these regions. Seven cases of PE occurring in an extreme HA region were prospectively collected at an HA (3,800 m) hospital from May to November 2020. All patients resided 5,000 m above sea level and were diagnosed with PE using computed tomography pulmonary angiography. Seven patients (24 ± 3.6 years old) had symptom onset at a mean altitude of 5,200 ± 200 m, and the duration spent at HA ranged from 8 to 210 days (99.29 ± 77.31 days). Cough, expectoration, chest tightness, fever, shortness of breath, and chest pain were the most common symptoms. Six of the seven patients were initially diagnosed with pulmonary inflammation, and four were diagnosed with high-altitude pulmonary edema using computed tomography or X-ray. Most patients presented with an increased concentration of inflammatory cells and high initial D-dimer levels. In this study, a retrospective analysis of PE case data in extreme HA areas suggested that PE was underdiagnosed owing to misdiagnosis or masking by HA-associated disease.
吴家林、韩小波、柯海文、王莉、王坤、张建利、唐军、严伟、王光军、姜鹏。极高海拔地区的肺栓塞：7例研究。2022年第23卷：209 - 214页。高海拔（HA）地区静脉血栓栓塞症（VTE）的发病率很高。我们分析了极高海拔地区的肺栓塞（PE）病例，以探讨这些地区PE的流行病学特征和危险因素。2020年5月至11月，在一家海拔3800米的HA医院前瞻性收集了7例发生在极高海拔地区的PE病例。所有患者居住在海拔5000米以上，通过计算机断层扫描肺动脉造影诊断为PE。7例患者（24±3.6岁）症状出现时的平均海拔为5200±200米，在HA地区停留的时间为8至210天（99.29±77.31天）。咳嗽、咳痰、胸闷、发热、气短和胸痛是最常见的症状。7例患者中有6例最初被诊断为肺部炎症，4例通过计算机断层扫描或X线被诊断为高原肺水肿。大多数患者出现炎症细胞浓度升高和初始D - 二聚体水平升高。在本研究中，对极高海拔地区PE病例数据的回顾性分析表明，由于误诊或被HA相关疾病掩盖，PE存在诊断不足的情况。
