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目的评价老年急性肺血栓栓塞症(pulmonary thromboembolism,PTE)患者危险因素及临床特征。方法回顾性分析454例急性PTE患者的临床资料,分为老年组(≥60岁,209例)和非老年组(<60岁,245例),比较两组患者危险因素及临床特征。结果老年组与非老年组相比,糖尿病(20.6%vs.9.0%)、高血压(53.6%vs.22.9%)、慢性心脏疾病(30.6%vs.8.6%)、慢性阻塞性肺病(COPD,11.0%vs.5.7%)、静脉曲张(12.9%vs.6.3%)、>1个月长期卧床者(13.4%vs.6.5%)、妇科手术(0.0%vs.5.3%)的比例差异有统计学意义(P均<0.05);老年组胸痛(23.9%vs.32.9%)、咯血(10.0%vs.20.4%)、影像学提示的大面积肺栓塞(29.2%vs.38.8%)的比例明显更低(P均<0.05);而休克(18.2%vs.10.2%)、低血压(20.1%vs.10.6%)的发生比例及院内死亡率(16.7%vs.6.5%)明显更高(P均<0.05);D-二聚体升高患者(96.2%vs.91.0%)比例更高(P<0.05)。结论老年急性PTE患者合并慢性疾病比例更高,长期卧床者更多;老年组患者病情往往更重,院内死亡率更高。
Objective To evaluate the risk factors and clinical features of elderly patients with pulmonary thromboembolism (PTE). Methods The clinical data of 454 acute PTE patients were retrospectively analyzed. They were divided into the elderly group (≥60 years, 209 cases) and the non-elderly group (≤60 years, 245 cases). The risk factors and clinical features of the two groups were compared. Results Compared with the non-elderly group, the incidence of diabetes (20.6% vs.9.0%), hypertension (53.6% vs.22.9%), chronic heart disease (30.6% vs.8.6%), chronic obstructive pulmonary disease 11.0% vs.5.7%), varicose veins (12.9% vs.6.3%), long-term bed rest for more than 1 month (13.4% vs.6.5%) and gynecologic surgery (0.0% vs.5.3% (P <0.05). The proportion of chest pain (23.9% vs.32.9%), hemoptysis (10.0% vs.20.4%) in the elderly group and the large pulmonary embolism (29.2% vs.38.8% (P <0.05). However, the incidence of shock (18.2% vs.10.2%), hypotension (20.1% vs.10.6%) and hospital mortality (16.7% vs.6.5%) were significantly higher (P (All P <0.05). The proportion of D-dimer was higher in patients (96.2% vs.91.0%) (P <0.05). Conclusions Elderly patients with acute PTE have a higher proportion of patients with chronic diseases and more prolonged bed-ridden patients. Elderly patients tend to be more severe and have a higher in-hospital mortality rate.