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急性中度风险肺栓塞后的呼吸困难：基于病例的评估与治疗方法

Dyspnea After an Acute Intermediate-Risk Pulmonary Embolism: A Case-Based Approach to Evaluation and Treatment.

作者信息

Zlotshewer Brooke, Oliveros Estefania, Meilli Zachary, Nasri Amine, Vaidya Anjali, Lakhter Vladimir, Sadek Ahmed S, Forfia Paul, Bashir Riyaz

机构信息

Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

Division of Cardiovascular Disease, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

出版信息

JACC Case Rep. 2024 Sep 18;29(18):102540. doi: 10.1016/j.jaccas.2024.102540.

DOI:10.1016/j.jaccas.2024.102540
PMID:39360003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11442200/
Abstract

Exercise intolerance after acute pulmonary embolism may be caused by residual pulmonary vascular obstruction, which presents as chronic thromboembolic pulmonary disease with or without pulmonary hypertension. We present a case highlighting a systematic approach to evaluating functional limitations due to residual pulmonary vascular obstruction, emphasizing the utility of cardiopulmonary exercise testing.

摘要

急性肺栓塞后运动不耐受可能由残留的肺血管阻塞引起，其表现为伴有或不伴有肺动脉高压的慢性血栓栓塞性肺疾病。我们报告一例病例，重点介绍一种评估因残留肺血管阻塞导致的功能受限的系统方法，强调心肺运动试验的实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/b43a181ec146/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/3ffeba65c3c4/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/65b008c805ce/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/8bbc13416ee4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/e12bf31b7c29/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/d698642a0eb0/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/8c935e3b85a8/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/6c0f0cdc11ce/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/b43a181ec146/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/3ffeba65c3c4/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/65b008c805ce/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/8bbc13416ee4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/e12bf31b7c29/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/d698642a0eb0/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/8c935e3b85a8/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/6c0f0cdc11ce/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ecc/11442200/b43a181ec146/gr7.jpg

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本文引用的文献

1
Residual pulmonary vascular obstruction and recurrence after acute pulmonary embolism: a systematic review and meta-analysis of individual participant data.急性肺栓塞后残余肺血管阻塞和复发：一项个体参与者数据的系统评价和荟萃分析。
J Thromb Haemost. 2023 Jun;21(6):1519-1528.e2. doi: 10.1016/j.jtha.2023.01.030. Epub 2023 Feb 3.
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2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.2022年欧洲心脏病学会/欧洲呼吸学会肺动脉高压诊断和治疗指南。
Eur Heart J. 2022 Oct 11;43(38):3618-3731. doi: 10.1093/eurheartj/ehac237.
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Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism.
肺栓塞患者残留肺阻塞对长期预后的影响。
Eur Respir J. 2017 May 25;49(5). doi: 10.1183/13993003.01980-2016. Print 2017 May.
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Functional and Exercise Limitations After a First Episode of Pulmonary Embolism: Results of the ELOPE Prospective Cohort Study.首次肺栓塞发作后的功能和运动限制：ELOPE前瞻性队列研究结果
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Residual pulmonary vascular obstruction and recurrence after acute pulmonary embolism. A single center cohort study.急性肺栓塞后残留肺血管阻塞及复发：一项单中心队列研究。
Thromb Res. 2016 Dec;148:70-75. doi: 10.1016/j.thromres.2016.10.030. Epub 2016 Oct 29.
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The post-PE syndrome: a new concept for chronic complications of pulmonary embolism.肺栓塞后综合征：肺栓塞慢性并发症的新概念。
Blood Rev. 2014 Nov;28(6):221-6. doi: 10.1016/j.blre.2014.07.003. Epub 2014 Aug 15.
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Long-term prognostic value of residual pulmonary vascular obstruction at discharge in patients with intermediate- to high-risk pulmonary embolism.中高危肺栓塞患者出院时残留肺血管阻塞的长期预后价值。
Eur Heart J. 2013 Mar;34(9):693-701. doi: 10.1093/eurheartj/ehs365. Epub 2012 Oct 26.