糖尿病肺血栓栓塞症的相关因素探讨

目的探讨DM患者PE的相关因素。方法对58例DM行双下肢超声检查和（或）^99m/Tc—MAA深静脉显像、肺灌注显像，同期获取血液及临床相关资料。结果28例DM下肢深静脉血栓形成（48．3％），8例并发PE（13．8％）；有DVT的DM的PE发病率（28．6％）明显高于无DVT患者（0）（x^2=7．69，P〈0．01），髂股深静脉DVT患者的PE发病率（44．4％）明显高于腘静脉以下DVT患者（0）（x^2=4．24，P〈0．05），有胸部症状的DM的PE发病率（50．0％）明显高于无胸部症状者（4．4％）（x^2=13．06，P〈0．01）；年龄、病程、糖尿病类型、血压、体重指数、血糖、血脂、血胆固醇、下肢症状、急性并发症10因素各自的PE发病率无显著性差异（x^2≤2．96，P〉0．05）。结论有髂股深静脉DVT的DM容易并发PE，有胸部症状的DM为PE的高危人群。

Study on Related Factors of Pulmonary Embolism in Diabetic Patients

Objective To study the related factors in diabetic patients with pulmonary embolism（PE）. Methods 58 diabetic cases underwent lower extremital doppler ultrasound and/or ^99Tc^m-MAA veins imaging and pulmonary perfusion imaging. The related datas of plasma and clinic were collected simultaneously. Results 28 patients（48.3%） were showed to be with lower extremital deep vein thrombosis（DVT） by 99Tc^m-MAA imaging, 8 cases（13.8%） with PE. The PE ratios（28.6%） of the patients with DVT was more higher than no DVT（0）（ x^ 2= 7.69, P〈 0.01）. The PE ratios （44.4%） of the patients with iliofemoral vein thrombosis was more higher than the patients with subpopliteal vein thrombosis （0） （ x^ 2 = 4.24, P 〈 0.05 ）. The PE ratios （50.0%） of the patients with chest symptoms （chest pain and short of breathe） was more higher than no symptoms（4.4%） （ x^ 2= 13.06,P〈 0.01 ）. The PE ratios were no significant difference to factors of age,disease courses,DM tape,hypertention,body massindex,blood long chain triglycerides,blood cholesterol,fasting blood glucose,lower extremital symptoms（swelling, crooted veins and diabetic foot） and acute complication （diabetic ketoacidosis and hyperosmolar non ketotic diabetic coma）（ x^ 2≤2.96,P〉 0.05）, respectively. Conclusion The serious DM with chest symptoms,lower extremital symptoms and/or acute complication are more higher risk population of PE. The high ratios of PE in DM with iliofemoral vein thrombosis is more higher than with subpopliteal vein thrombosis.