The Analysis Of Risk Factors For Recurrent Pulmonary Embolism

BackgroundPulmonary thromboembolism (PTE) is a kind of high dangerous and deadlycardiopulmonary disease.It has three characteristics: high misdiagnosis rate, highmissed diagnosis and high mortality rate.At present, pulmonary embolism hasdeveloped from a rare disease in which people thought into multiple disease, and thediagnostic rate of PTE has been inproving, the main reason is relative to clinicianswho had the continuous improvement of technical knowledge and diagnosis andtreatment of the disease.Although people have attaches great importance to thediagnosis of pulmonary embolism, but its mortality rate is still highly. Breathing andcirculation dysfunction after acute pulmonary embolism are often the chief causes ofdeath, after thrombolysis and anticoagulant therapy actively,the mortality hasreduced. The study found that even if give a proper treatment, there are still somepatients experienced a recurrence pulmonary embolism, the mortality rate that acutehemorrhage caused by recurrence of pulmonary embolism has no obviousdecline.Therefore, to investigate the risk factors of recurrent pulmonary embolism, toimprove the recognition of the recurrence of pulmonary embolism events is theprevention and treatment of pulmonary embolism. Only fully understand the riskfactors of recurrence of pulmonary embolism, could help predict early the recurrenceof PTE, which could early intervene, may reduce the recurrence, in order to reducethe fatality rate of PTE.ObjectiveAnalysis the clinical data of patients with recurrent pulmonary embolism,including gender, age, risk factors, D-dimer level, anticoagulant therapy, etc.,improving the level of early diagnosis in patients with recurrent pulmonaryembolism. MethodsA retrospective analysis in January2009to December2012in the firstaffiliated hospital of zhengzhou university, the clinical data of342patients withincipient pulmonary embolism. Whether the patients with pulmonary embolismoccurs again,we divided patients into recurrence group and unrelapse group, andcompared the difference of risk factors between two groups.ResultsIn pulmonary embolism without recurrence group, the male patients with158cases (52.67%), while female patients with142cases (47.33%), and the recurrencegroup, male and female patients all21cases (50%).PTE did not relapse group and nogender difference between recurrence group has no statistical significance (P＞0.05),while the two groups in age difference was statistically significant (P＜0.05). In riskfactors analysis, Braking for a long time, smoking, older age, lower extremityvaricose veins, hypertension, coronary heart disease, malignant tumor, nephroticsyndrome, disease of grow in quantity of red blood cells and idiopathic PTE in in thedifferences between the two groups were statistically significant (*P＜0.05), surgicaltrauma, pregnancy/oral contraceptives, diabetes, no statistical differences between thetwo groups have no statistical difference (P＞0.05).In all of342patients with PTE D-dimer data integrity.D-dimer,66cases of continuous positie and negatie in138cases.Which recur group D-dimer was14cases (33.33%), D-dimer negatie8cases(19.04%).When the PTE patients after initial therapy for sustainable D-dimer ispositive, there had to embolism rate is relatively high D-dimer negative, thedifference was statistically significant (P＜0.05). Relapsed patients for a short periodof treatment of anticoagulant was7cases (16.67%), for a long period of treatment ofanticoagulant was35cases (83.33%).Receive long-term anticoagulation therapy (＞3months) in patients with pulmonary embolism and thrombosis rate relativelyshort-term anticoagulation (＜3months) is low, the difference was statisticallysignificant (P＜0.05). In multi-factor unconditional logistic regression analysis, theelderly (＞65, OR=8.613, P＜0.05), lower extremity varicose veins (OR=10.017, P＜0.05), malignant tumor (OR=5.228, P＜0.05), nephrotic syndrome (OR=4.806, P＜0.05), idiopathic PTE (OR=7.634, P＜0.05), continuous D-dimer rise (OR=3.92, P＜0.05), short course (OR=5.357, P＜0.05) as the independent risk factors forrecurrence of pulmonary embolism, and long-term brake, smoking, hypertension andcoronary heart disease (CHD) in multi-factor analysis has no statistical significance(P＞0.05).ConclusionsBraking for a long time, smoking, elderly (＞65years), lower extremity varicoseveins, hypertension, coronary heart disease, malignant tumor, nephrotic syndrome,disease of grow in quantity of red blood cells and idiopathic PTE, elevatedsustainable D-dimer, and short course of anticoagulant therapy are the risk factors forrecurrence of pulmonary embolism.the elderly (＞65years), lower extremity varicoseveins, malignant tumor, nephrotic syndrome and idiopathic PTE, elevated sustainableD-dimer, and short course of anticoagulant therapy will be the independencedangerous factor. its can be used as a predictor of recurrence in patients withpulmonary embolism.