深静脈血栓症の患者で頻繁に無症状の肺栓塞が発生する

K M Moser¹, P F Fedullo, J K LitteJohn

¹Department of Medicine, University of California, School of Medicine, San Diego.

JAMA

|January 19, 1994

まとめ

症状のない深静脈血栓症患者の約40%が肺栓塞を発症しました. これは,静脈性血栓塞栓症が単一の状態であることを強調し,包括的な診断と治療の必要性を強調しています.

科学分野:

心臓病学心臓病学
肺内科肺内科肺内科
血管医学血管医学とは

背景:

深静脈血栓症 (DVT) と肺栓塞 (PE) は静脈血栓塞栓症 (VTE) の表れである.
DVTと診断された患者の無症状PEの頻度はよく確立されていません.
DVTとPEの関係を理解することは,効果的な患者管理に不可欠です.

研究の目的:

深静脈血栓症 (DVT) 治療のために入院した患者の肺栓塞 (PE) の発生率を決定する.
DVTと無症状PEの関係を調査する.

主な方法:

5つの高等保健病院を対象とした,オープンで多センターで投与範囲を決定する研究です.
DVTまたはPEが確認された患者は,治療前のおよび後の診断画像 (静脈図,肺血管図,肺スキャン,胸部レントゲン図) を受けました.
すべての患者は組織型プラズミノゲン活性化剤を受け,その後ヘパリン療法を受けた.

主要な成果:

DVTとPEの症状のない患者の約40%は,呼吸器 perfusion スキャンと胸部レントゲノグラムで肺栓塞の証拠を示しました.
これらの発見は,高い確率のスキャン結果に基づいており,最小の発生率を示唆しています.

結論:

DVT患者における無症状PEの高頻度は,静脈血栓塞栓症を単一の疾患プロセスとして見るべきであることを示しています.
これらの結果は,明白な症状のない患者でも,すべてのDVT患者でPEを検討することの重要性を強調しています.

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