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症状暗示肺栓塞后综合征和使用诊断测试的症状
Vikas Aggarwal1,2, S Nabeel Hyder1, Neil Kamdar3,4,5
1Division of Cardiology (Frankel Cardiovascular Center), Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
概括
肺栓塞后综合征 (PPES) 影响了急性肺栓塞 (PE) 后超过一半的患者. 在这个人群中,诊断测试的使用不足,特别是在老年人中.
科学领域:
- 肺部病理学 肺部病理学
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 肺栓塞后综合征 (PPES) 包括急性肺栓塞 (PE) 发生三个月后出现的呼吸障碍和疲劳等持续症状.
- 虽然被认为是PE的显著长期并发症,但PPES的实际发病率和诊断工作模式仍然不清楚.
- 了解PPES的发生率和诊断测试的利用对于管理长期PE后续来说至关重要.
研究的目的:
- 确定一组被诊断患有急性PE的全国患者中的PPES当代发病率.
- 评估在患有PPES的患者中用于表型特征的诊断测试的使用情况.
- 为了确定影响PPES患者诊断测试使用的因素.
主要方法:
- 使用Clinformatics DataMart数据库 (Optum Insight) 进行了一项回顾性队列研究.
- 包括在2016年10月1日至2018年12月31日期间被诊断患有急性PE的成年患者,之前没有PE或肺高血压.
- 评估了PPES症状的发生率和PE后3-12个月内诊断测试的使用率.
主要成果:
- 在21297名急性PE患者中,11969人 (56.2%) 出现了与PPES相一致的症状.
- 新出现的呼吸障碍 (21.5%) 和疲劳 (18.5%) 是最常见的症状.
- 只有42.8%的PPES患者接受了诊断测试,CT肺血管造影和心声造影是最常见的;老年患者 (>65岁) 显示测试利用率明显较低.
结论:
- 标志着PPES的症状非常普遍,在急性PE后影响超过一半的患者.
- 对PPES表型的诊断测试在不到一半的受影响患者中未得到充分利用.
- 年龄是诊断测试利用的一个重要因素,老年人接受的测试较少.
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