The Explore The Clinical Characteristics And Pathological Of Nephritic Syndrome With Pulmonary Embolism Related Risk

Objective:We analyzed clinical of nephrotic syndrome with pulmonary embolism and associated risk factors, diagnosis and treatment are summarized experience, improve the diagnosis and treatment of disease and reduce mortality.Methods:A retrospective study from January 2009 to January 2015 at the First Affiliated Hospital of Guangxi Medical University hospital,60 patients met the diagnosis of nephrotic syndrome, and simultaneously CTPA to determine whether the merger of cases of pulmonary embolism, divided embolization group embolization group and not for all the patient’s sex, age, time of onset, and the risk factors that may exist manifested clinical symptoms, and related laboratory laboratory examinations, histological type, single factor analysis, and then use the Logistic Regression analysis independent risk factor screening, according to the independent risk factor screening and the use of receiver operating characteristic curve (ROC curve), determined based on the evaluation of pulmonary embolism in the nephrotic syndrome and thresholds, and also for the treatment and prognosis analysis.Results:A total of 60 cases of patients included in the analysis.32 cases suggestive of pulmonary embolism after CTPA examination, no embolism after another 28 cases CTPA examination. Embolization group of patients did not usually caused by chest tightness, chest pain when breathing difficulties and other selected row CTPA examination to exclude, in the relevant risk factors, the univariate analysis showed that hemoglobin, serum albumin, cholesterol, low-density lipoprotein, D-two mer, P2 hyperthyroidism (P<0.05), there are significant differences, chest tightness, chest pain, breathing difficulties and other PTE showed no independent association, these differences were statistically univariate analysis using Logistic regression multivariate analysis to detect independent risk factors, found that only D-dimer is an independent risk factor for PTE and analyze ROC curves show D-dimer optimal thresholds: 1015.50μg/L. Cases of pulmonary embolism group 22 males and 10 females, mean age 40.80 years old, suffering from NS average time 8.92 months,Pathology in idiopathic membranous nephropathy mainly (33.3%), followed by lupus nephritis (28.6%), diagnosed after row CTPA examination, two cases taken thrombolytic the rest were using subcutaneous low molecular weight heparin, or warfarin joint,3 deaths,2 cases of recurrent exacerbation, the rest were discharged improved,27 cases were followed up their patients got better, lost two cases, relapse 2 cases.Conclusion:1. D-dimer is an independent risk factor of nephrotic syndrome and pulmonary embolism, need to guard against pulmonary embolism occurs when patients with nephrotic syndrome D-dimer greater than 1015.50μg/L.2. Pathological types of nephrotic syndrome patients complicated with PTE to idiopathic membranous nephropathy common, followed by lupus nephritis.3. NS patients with symptoms of chest pain, breathing difficulties, we need to combine blood gases, D-dimer, electrocardiogram, laboratory tests and other symptoms other signs determine the possibility of the occurrence of pulmonary embolism. Easy to induce attention to risk factors associated with pulmonary embolism, PTE eliminate the incentive to improve the hypercoagulable state, early diagnosis, treatment and improve the prognosis is very important.