Yang Geng, Nie Shaoping
Emergency Rescue Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
J Thorac Dis. 2025 Mar 31;17(3):1552-1560. doi: 10.21037/jtd-24-1293. Epub 2025 Mar 13.
Pulmonary embolism (PE) is characterized by a high rate of misdiagnosis and poor prognosis. This descriptive epidemiological study aimed to identify modifiable risk factors for PE through an age- and sex-matched case-control study.
The case group consisted of patients diagnosed with PE at Beijing Anzhen Hospital, within a 3-year period. Age- and sex-matched controls were randomly selected from individuals who participated in health check-ups at the same institute during the same period. Clinical variables, including histories of hypertension, diabetes, body mass index (BMI), smoking, systolic blood pressure (SBP), and obstructive sleep apnea-hypopnea syndrome (OSAHS), were analyzed in 129 case-control pairs.
In univariate analysis, significant risk factors for PE included OSAHS, smoking, triglycerides, and estimated glomerular filtration rate (eGFR). In multivariate analysis, using a conditional logistic regression model, OSAHS [P=0.01; odds ratio (OR), 3.100; 95% confidence interval (CI): 1.202-7.994], hypertension (P=0.02; OR, 2.212; 95% CI: 1.107-4.420), and smoking (P<0.001; OR, 7.167; 95% CI: 3.302-15.556) were identified as independent risk factors for PE. No significant associations were observed between triglycerides or eGFR and PE. Additionally, a negative correlation between arterial partial pressure of carbon dioxide (PCO) and PE was observed in the multivariate analysis (P=0.02; OR, 0.946; 95% CI: 0.904-0.990). A risk model and scoring system with strong discriminatory power were developed (adjusted OR, 1.129; 95% CI: 1.021-1.248).
The findings suggest that OSAHS, hypertension, and smoking are strongly associated with PE, while arterial PCO may exhibit a protective correlation with PE risk.
肺栓塞（PE）具有误诊率高和预后差的特点。这项描述性流行病学研究旨在通过一项年龄和性别匹配的病例对照研究确定PE的可改变风险因素。
病例组由北京安贞医院在3年内诊断为PE的患者组成。年龄和性别匹配的对照组从同期在同一机构参加健康体检的个体中随机选取。对129对病例对照进行了临床变量分析，包括高血压病史、糖尿病、体重指数（BMI）、吸烟、收缩压（SBP）和阻塞性睡眠呼吸暂停低通气综合征（OSAHS）。
在单因素分析中，PE的显著风险因素包括OSAHS、吸烟、甘油三酯和估算肾小球滤过率（eGFR）。在多因素分析中，使用条件逻辑回归模型，OSAHS[P = 0.01；比值比（OR），3.100；95%置信区间（CI）：1.202 - 7.994]、高血压（P = 0.02；OR，2.212；95% CI：1.107 - 4.420）和吸烟（P < 0.001；OR，7.167；95% CI：3.302 - 15.556）被确定为PE的独立风险因素。未观察到甘油三酯或eGFR与PE之间存在显著关联。此外，在多因素分析中观察到动脉二氧化碳分压（PCO）与PE之间存在负相关（P = 0.02；OR，0.946；95% CI：0.904 - 0.990）。开发了具有强大鉴别力的风险模型和评分系统（调整后OR，1.129；95% CI：1.021 - 1.248）。
研究结果表明，OSAHS、高血压和吸烟与PE密切相关，而动脉PCO可能与PE风险呈保护性相关。
