血栓负荷在急性中危肺血栓栓塞症中的临床意义

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Abstract Objective To investigate the clinical value of thrombotic load in acute intermediate-risk pulmonary thromboembolism (PTE). Methods A retrospective analysis was conducted on 128 patients admitted to Hunan Provincial People's Hospital who were diagnosed with acute intermediate-risk PTE by CT pulmonary angiography (CTPA) examination, and who were divided into intermediate-low-risk group and intermediate-high-risk group according to the risk stratification, including 62 cases in intermediate-high-risk and low risk group and 66 cases in intermediate-low-risk group, and who were analyzed in the general clinical data, right ventricular inner diameter (RV) and left ventricular inner diameter (LV) of echocardiography, RV and LV and thrombotic load/CT pulmonary artery occlusion index (PAOI) Qanadli score of CTPA. Qanadli score for thrombotic load and the RV/LV ratio of CTPA and echocardiography were compared. Receiver operating characteristic curve (ROC) was used to analyze the predictive ability of Qanadli score for acute intermediate-risk PTE. Results There were no statistical differences in age and sex of intermediate-low-risk group and intermediate-high-risk group. There were significant differences in shortness of breath, syncope and concomitant disease renal insufficiency, DVT in the two groups. Qanadli score, RV/LV ratios of CTPA and echocardiogram of patients in intermediate-low-risk group were significantly lower than those in intermediate-high-risk group. Qanadli score was positively correlated with RV/LV ratios of CTPA and echocardiographic. Qanadli score had good predictive value for intermediate-high-risk PTE, with an area under the ROC curve (AUC) of 0.814, a truncation value of 32.5%, a sensitivity of 77.3%, and a specificity of 77.4%. The result of univariate logsitic regression analysis showed that the high Qanadli scores (≥32.5%) were significantly more likely to be intermediate-high-risk than the low Qanadli scores (<32.5%) (OR=11.657). Conclusion Qanadli score was a predictor of risk stratification of intermediate-risk PTE, which provided a strong supplement for risk stratification, and reference value for clinicians who timely and accurately assessed the severity of the disease and personalized treatment.

Key words： pulmonary thromboembolism CT pulmonary artery obstruction index Qanadli score thrombotic load

Received: 03 July 2022

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R563.5

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	Articles by authors
	DUAN Xiaoju
	JIANG Gang
	SHI Lifang
	LI Lingjiao
	OUYANG Wen
	ZHENG Zhaofen

Cite this article:

DUAN Xiaoju,JIANG Gang,SHI Lifang等. Clinical study of thrombotic load in acute intermediate-risk pulmonary thromboembolism[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(3): 54-57.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I3/54

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