Clinical Characteristics Of Pulmonary Embolism And Age Differences In Research

ObjectiverResearch Young and middle-aged patients group and the elderly group first diagnosed with clinical cases of pulmonary embolism in the Wells score, clinical symptoms, signs, secondary risk factors, laboratory and imaging and history index difference;Discuss the common signs and symptoms, risk factors and pulmonary embolism laboratory or imaging diagnostic methods positive rate;Discussion on easy way to improve the new diagnostic method of pulmonary embolism.Methods:ESC in 2014 for the diagnosis and treatment of pulmonary embolism guide [1] and the Chinese medical association respiratory in 2001 for the diagnosis and treatment guidelines (draft) of pulmonary thromboembolism,adopts the method of retrospective study, selection of our hospital time in December 2010 to December 2015 in the hospital during the first 195 patients diagnosed with pulmonary embolism, including CT pulmonary angiography in the diagnosis of 124 cases, pulmonary artery angiography in the diagnosis of 71 cases,4 cases died, the age range is 23～90, the average (61.5+13.5) years old, male 78, female 117 cases.On the basis of [2] by the standard of human age, WHO at age< 60 years old for young and middle-aged patients group, including 83 patients, male 33 cases, female 50 cases, the average age (48.7+8.2);≥ 60 age for the elderly group, including 112 patients,45 cases of male, female 67 cases, the average (71.0-7.4).Respectively collected the clinical data of patients, including common secondary risk factors, clinical symptoms, signs and laboratory and radiographic and history positive index, Wells score, risk stratification, the young and middle-aged patients group for the statistical analysis and elderly group in patients with pulmonary embolism.Results:1.Young and middle-aged group and elderly group were significant differences in the Wells score (z= 2.524,p= 2.524< 0.05).2.Young and middle-aged group and elderly group (p= 0.000< 0.000) in cardiovascular disease and stroke (p= 0.004< 0.05) on the incidence of secondary risk factors have obvious difference.3.The top five most common secondary pulmonary embolism risk factors of cardiovascular disease, deep vein thrombosis, hyperlipidemia, long-term brake/bed, malignant tumor.4.Young and middle-aged group and elderly group in hemoptysis (0.000< 0.05), the typical views on pulmonary infarction (0.024< 0.05) on the clinical symptom significantly statistical difference.5.The most common symptoms of pulmonary embolism for exertional dyspnea (58.97%), the most common symptoms of respiratory frequency (43.08%).6.Age correction D-dimer (80.51%) and arterial blood gas analysis (47.69%) for the high sensitivity of pulmonary embolism in the early screening laboratory examination method.7.Young and middle-aged group and elderly group, respectively, using the highest rate of risk factors, symptoms and laboratory examination index, meet at least two positive suspected diagnosis of pulmonary embolism, the result of pulmonary embolism was positive rate are 72.29% and 72.29% respectively.Conclusion:1.The Wells score evaluate the sensitivity of pulmonary embolism in patients with young and middle-aged possibility than older patients.2.The disease of heart head blood-vessel as pulmonary embolism secondary risk factors, plays a more important role in older patients.3.Deep vein thrombosis in young and middle-aged and elderly patients are important secondary risk factors of pulmonary embolism.4.Hemoptysis and typical views on pulmonary infarction in young and middle-aged pulmonary embolism in patients with positive rate is higher than older patients.5.Exertional dyspnea and respiratory frequency (> 20 times/min), respectively, for the most common symptoms and physical signs, pulmonary embolism.6.Increasing age correction D-dimer and arterial blood gas analysis are more sensitive for the diagnosis of pulmonary embolism in patients with suspected laboratory and imaging diagnostic methods.7.Young and middle-aged blood gas analysis in patients with pulmonary embolism in low carbonic acid concentration is greater than the risk of elderly patients.8.Clinical cases with history of cardiovascular disease (age 60 or higher)/deep vein thrombosis (< 60 years old), age correction exertional dyspnea, plasma D-dimer rise at least two positive in the three early screening in patients with pulmonary embolism can be as good as indicators.