The Study Of Factors Related To The Thromboembolism Absorption Of Pulmonary Thromboembolism

Objective:To investigate factors of thrombosis absorption of pulmonary arterial thrombosis in patients with pulmonary thromboembolism (PTE).Methods:Sequentially selected the patients with PTE at First Affiliated Hospital of Dalian Medical University from January2009to December2013.The patients were first diagnosed by CT pulmonary angiography (CTPA), they got standardized therapy of anticoagulation and regularly reviewed CTPA(1month,3months,6months,12month,18months after diagnosis),150cases are enrolled. Analyzing the correlation of age, sex, risk factors and underlying disease with extent of absorption of CTPA thrombosis (pulmonary embolism index). CTPA pulmonary embolism index (PAOI) is assessing by Qanadli and Mastora methods. The inside diameter ratio of right ventricular and left ventricular (RV/LV) were measured at the same time.Results:1.There are71cases of male patients (47.6%) and79cases of female patients (52.4%) in150patients. The mean age is61+14years old (20years old-86years old)。2. The proportion of150patients with complete absorption time was as follows:the first month is30%(8/27), the third months71.4%(35/49), the sixth month is81.4%(35/43), the12month is69.0%(20/29) and the18months is73.7%(14/19).3. The comparison between the thrombus completely absorbed and unabsorbed group.At the first month:The analysis results of single factor showed the correlation between lower deep venous thrombosis (DVT) and the thrombus can be fully absorbed (P<0.05);But the age, sex, risk factors, improve pulmonary embolism severity index (simple pulmonary embolism severity index, sPESI), Gevena score have not correlation with thrombus can be completely absorbed (P>0.05);The datas of DVT and gender (p=0.075) are analyzed by multi-factor unconditioned logistic regression analysis found that the DVT (p=0.05, OR=6.500) is an independent risk factors of thrombosis can fully absorbed in patients with pulmonary embolism at the first month after diagnosed.At the third month and the sixth month:The single factor analysis showed that age, gender, DVT, risk factors, sPESI, Gevena score have not correlation with thrombus completely absorbed (P>0.05).At the12months:The single factor analysis results showed that the thrombus absorbed completely correlated with age (t=2.586,p=0.015); But there are no correlation with sex, DVT, susceptible factors, sPESI, Gevena score (P>0.05); Analyzing the age and Gevena score (p=0.064) by logistic regression analysis found that age (p=0.029, value OR=0.029) is an independent risk factors of thrombosis absorbed completely in patients with PTE at the twelfth month after diagnosed.At the18month:The single factor analysis results showed that age and DVT are correlated with thrombus absorbed completely (P<0.05); But there are no correlation with sex, susceptible factors, sPESI, Gevena score (P>0.05);Analyzing the age, DVT and Gevena score(p=0.087) by multi-factor unconditioned logistic regression analysis found that age (p=0.041, OR=0.873) is an independent risk factors of thrombosis absorbed completely in patients with PTE at the18month after diagnosed.4. There was positive correlation between RVd/LVd and Qanadi PE index(r=0.578, P=0.000), Mastora PE index (r=0.514, P＝0.000)5. Qanadi PE index and Mastora PE index are the median25.47%,11.94%in150cases of PTE patients. Qanadi PE index had a difference with Mastora PE index (Z=-7.116, P=0.000) and with a positive correlation (r=0.876, P=0.000).Conclusion:1. The highest rate of thrombosis completely absorpted occurred in sixth month after the standard treatment of pulmonary thro mbo embolism2. Age and whether absorption merger DVT is risk factors for thrombotic pulmonary thromboembolism, DVT is the independent risk factor of thrombosis absorption recently(less than6months), while age is its long-term (more than6months) were independent risk factors.3. There was positive correlation between RVd/LVd and Qanadi PE index and Mastora PE index. Qanadi PE index had a positive correlation with Mastora PE index.