真实世界中肺栓塞后慢性血栓栓塞性肺动脉高压的发病及相关危险因素前瞻性研究
收稿日期: 2019-01-31
网络出版日期: 2019-02-25
A prospective study on incidence of chronic thromboembolic pulmonary hypertension after pulmonary thromboembolism
Received date: 2019-01-31
Online published: 2019-02-25
关键词: 肺; 慢性血栓栓塞性肺动脉高压; 危险因素; 累积发病率
魏晓敏, 张媛媛, 董樑, 夏敬文, 龚益, 喻永平, 李圣青 . 真实世界中肺栓塞后慢性血栓栓塞性肺动脉高压的发病及相关危险因素前瞻性研究[J]. 诊断学理论与实践, 2019 , 18(1) : 37 -43 . DOI: 10.16150/j.1671-2870.2019.01.008
Objective: To explore the incidence of chronic thromboembolic pulmonary hypertension (CTEPH) in a series of patients with symptomatic pulmonary embolism(PE) diagnosed for the first time and receiving adequate anticoagulant treatment no less than 3 months, and to assess the risk factors of CTEPH in these patients. Methods: A prospective, long-term, 3 years follow-up study was conducted to assess the incidence and risk factors of CTEPH in 292 patients with PE diagnosed for the first time. Results: The cumulative incidence of CTEPH in 292 patients with PE diagnosed for the first time was 9.20% at three months, 10.40% at six months, 11.30% at one year, 11.90% at two years, and 12.90% at three years. The following factors increased the risk of CTEPH: time from symptoms to treatment of PE≥1 month (odds ratio OR=9.065), the intermediate risk PE (OR, 37.691) to high risk PE (OR=33.957); segmental and sub-segmental branch location of embolism (OR=6.216), the PE related primary risk factors (OR=3.659). Conclusions: The cumulative incidence of CTEPH in patients with PE is 12.90% at three years.CTEPH is a common complication in PE patients diagnosed for the first time.
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