儿科肺栓塞中肺梗塞的预测因素:一个回顾性队列研究
Shuxuan Li1, Min Wang2, Yongsheng Xu2
1Clinical School of Paediatrics, Tianjin Medical University, Tianjin, China.
Thrombosis research
|October 14, 2025
概括
在患有肺栓塞 (PE) 的儿童中,肺梗塞 (PI) 是罕见的. 胸部疼痛,血中尿素 (BUN) 的升高,以及高温是PI的关键危险因素. 一个逻辑回归模型显示了预测儿科患者PI的前景.
科学领域:
- 儿科肺病学 儿科肺病学
- 心血管成像 - 心血管成像
- 血栓形成研究研究
背景情况:
- 肺梗塞 (PI) 是儿科患者肺栓塞 (PE) 的不常见并发症.
- 确定儿童PI的风险因素和预测指标对于及时诊断和管理至关重要.
- 在现场肺动脉血栓形成是这个年龄组中主要的PE形式.
研究的目的:
- 在患有肺栓塞 (PE) 的儿科患者中确定与肺梗塞 (PI) 发展相关的风险因素.
- 评估儿童PI的各种预测指标和评分系统的诊断实用性.
- 评估物流回归模型在预测PI方面的有效性.
主要方法:
- 通过计算机断层扫描血管造影 (CTA) 诊断出PE的儿科患者 (<18岁) 的回顾性研究.
- 数据收集包括人口统计,病史,临床发现,实验室结果和成像.
- 分析涉及后勤回归和接收器运行特征 (ROC) 曲线,以确定风险因素并评估评分系统的诊断性能 (简化Wells,修订日内瓦,PE严重性指数).
主要成果:
- 在41名儿科PE患者中,15名患有PI. 深静脉血栓症在95%的病例中没有出现.
- 简化威尔斯,修订日内瓦和PE严重性指数得分显示,儿童PE或PI的预测性表现不佳.
- 独立的PI风险因素包括胸痛 (aOR=6.85),血尿素 (BUN) (aOR=2.77) 和最高温度 (aOR=3.83).
- 一种后勤回归模型在PI预测中获得了0.846的AUC,显著超过了简化的威尔斯得分 (AUC=0.640).
结论:
- 胸部疼痛,BUN升高和最高温度是儿科PEPI的重要独立风险因素.
- 后勤回归模型在预测PI方面表现出高效率,这表明开发专门的儿科PI评分系统的潜力.
- 这些发现强调了临床症状和基本实验室值在识别患有心脏病发作风险的儿科PE患者中的重要性.
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