Analysis Of Clinical Features And Risk Factors Of Patients With Connective Tissue Disease Complicated With Pulmonary Embolism

Objective: To analysis the clinical characteristics and risk factors of Connective Tissue Disease(CTD)combined with Pulmonary Embolism(PE).Methods: In this study,by using the electronic medical record system of the First Affiliated Hospital of Kunming Medical University,we retrospectively analyzed47 patients diagnosed with connective tissue disease complicated with pulmonary embolism in our hospital from September 2016 to December 2022 as the case group,and searched a total of 873 patients diagnosed with connective tissue disease without pulmonary embolism in our hospital during the same period,using isometric sampling method to select 47 patients with connective tissue disease during the same period as the control group.Patients’ basic clinical information,clinical signs and laboratory results were recorded in detail.The data collected above were summarized and analyzed,and the independent risk factors of connective tissue disease complicated with pulmonary embolism were explored through univariate analysis and Chi-square test.Results:1.47 patients with connective tissue disease were included in this study,including 10 males and 37 females,with an average age of 47.66±12.13 years.There were 47 patients with connective tissue disease complicated with pulmonary embolism,including 11 males and 36 females.The mean age of the patients was61.79±12.12 years old.The age of the patients with connective tissue disease complicated with pulmonary embolism was significantly older than that of the patients with connective tissue disease(P<0.001).There was no difference in BMI between the two groups.2.There were no significant differences in the expressions of leukocytes,neutrophils,lymphocytes,monocytes,platelets and hemoglobin,and the differences were not statistically significant.The number of red blood cells in patients with connective tissue disease combined with pulmonary embolism was 4.32±0.81,slightly higher than that in patients with connective tissue disease alone(3.96±0.73),but the difference was statistically significant(P=0.025).3.There was no difference in liver and kidney function except creatinine increase in pulmonary embolism group.The levels of albumin and high density lipoprotein were lower than those of connective tissue disease,and the differences of albumin(P=0.035)and high density lipoprotein(P=0.021)were statistically significant.4.The activation partial thromboplastin time was 25.86±4.05 seconds in patients with connective tissue disease combined with pulmonary embolism,and 32.75±5.08 seconds in patients with connective tissue,the difference was statistically significant(P<0.001).The prothrombin time in patients with connective tissue disease combined with pulmonary embolism was 11.98±1.29 seconds,the activated partial thrombin time in patients with connective tissue was 12.51±1.12 seconds,the difference was statistically significant(P=0.034).The average expression level of D-dimer in patients with connective tissue was 0.54 gm/L,while that in patients with connective tissue disease combined with pulmonary embolism was 3.69 gm/L,with statistical significance(P<0.001).5.The expression level of C-reactive protein in patients with connective tissue disease was 3.9 mg/L on average,while that in patients with connective tissue disease complicated with pulmonary embolism was 20.5 mg/L on average,and the difference was statistically significant(P<0.001).The mean ESR of connective tissue patients was 29 mm/H,while that of patients with connective tissue disease combined with pulmonary embolism was 55 mm/H,the difference was statistically significant(P=0.045).6.There was no significant difference in C3,Ig G,Ig A,Ig M and other indexes of autoantibody.There was statistical significance in C4 indexes of patients with connective tissue disease combined with pulmonary embolism(P=0.044).7.There were no significant differences in gender,smoking,drinking,hypertension,hormone using and pulmonary infection.8.Patients with connective tissue disease combined with dyspnea,chest pain,hemoptysis,positive signs of lower extremity,venous thrombosis of lower extremity,pleural effusion,pulmonary hypertension and pulmonary artery widening pressure are more likely to have pulmonary embolism.Conclusions:1.The older the patients with connective tissue disease are,the more likely they are to develop pulmonary embolism,and the lack of specific clinical characteristics after the onset.2.The occurrence of pulmonary embolism should be vigilant when connective tissue disease is combined with dyspnea,chest pain,hemoptysis,positive signs of lower extremities,pleural effusion,pulmonary hypertension and pulmonary artery widening pressure.3.Age,D-dimer,lower limb thrombosis and C-reactive protein were risk factors of connective tissue disease combined with pulmonary embolism;The increase of APTT is a protective factor of connective tissue disease with pulmonary embolism.