Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases | 2019
[Clinical characteristics of acute pulmonary embolism at different altitudes in plateau areas].
Abstract
Objective: To analyze the clinical characteristics of pulmonary embolism patients from different altitudes in plateau areas. Methods: A retrospective cross-sectional study was used to analyze the patients with acute pulmonary embolism diagnosed definitely by pulmonary angiography or pulmonary artery CT angiography admitted to Tibet Autonomous Region People s Hospital from August 2014 to December 2018. The subjects were divided into 3 groups according to the altitude of long-term residence before onset, i.e. low-altitude group (group 1, 2 700 m ≤ altitude ≤3 700 m, n=44), medium-altitude group (group 2, 3 700 m<altitude ≤4 000 m, n=30) and high altitude group (group 3, 4 000 m<altitude ≤4 800 m, n=32). The clinical data, auxiliary examination and risk stratification of pulmonary embolism patients at different altitudes were compared and analyzed. Results: The incidence of chest pain, dyspnea and lower limb fracture in the three groups were statistically significant (P<0.05). The incidence of chest pain in group 2 (70%) was higher than that in group 1(40.9%), and dyspnea in group 3 (93.8%) was higher than that in group 2(66.7%), while lower limb fracture in group 3 (43.8%) was higher than that in group 1(15.9%). The differences in arterial oxygen partial pressure, hemoglobin and D-dimer among the three groups were statistically significant (P<0.05). The arterial oxygen partial pressure [52(43.5-63.5)mmHg] in group 3 was lower than that in group 1 [60 (53.25-73) mmHg]. The hemoglobin (163.1±43.3 g/L) and D-dimer [5.6(3.7-12.6)mg/L] in group 3 were higher than those in group 1 [143.5±38.9 g/L and 3.8(2.0-7.5)mg/L respectively]. The risk stratification of the three groups of patients was moderate or low, and there was no statistical difference among the three groups. In patients with the same low-risk grade, the D-dimer in group 3 was higher than that in group 1 [5.8(4.2-14.8)mg/L and 3.6(2.3-5.8)mg/L respectively, P<0.05]. In patients with the same moderate risk level, the arterial oxygen partial pressure in group 3 was lower than that in group 1 [47.0(36.0-58.0)mmHg and 59.5(52.3-68.5)mmHg, respectively, P<0.05]. Conclusion: There was no difference in the risk stratification of pulmonary embolism from different altitudes in plateau areas, but patients who lived at higher altitudes for a long time showed more significant hypoxemia and increased hemoglobin and D-dimer levels.