| [Objective]To analysis the risk factors and clinical features of pulmonary thromboembolism(PTE)in young age patients,to help clinicians improve their understanding of young PTE patients,and to avoid missed diagnosis and misdiagnosis.[Methods]120 PTE patients with the age of 14-40 diagnosed by CT pulmonary angiography or echocardiography according to the recommendation of“2010 Chinese Expert Consensus”issued by the Society of Respiratory Diseases admitted in the first affiliated hospital of Kunming Medical University between January,2014 and December,2018 were recruited in the study.The patient’s name,gender,age,major clinical symptoms,signs,long-term sitting/lying condition,height and weight,smoking history,history of surgical trauma,medication history,past medical history,family history,CT pulmonary angiography,echocardiography,and electrocardiogram were collected,vascular ultrasound of the extremities,D-Dimer,arterial blood gas,tumor marker,plasma homocysteine and other data were collected and retrospective analysis of clinical features and related risk factors of PTE were conducted.The database was established by Excel,and SPSS 21.0 was used for statistical description.The measurement data was expressed as mean±standard deviation(±S),and the count data was expressed as a percentage of the number n(%).[Results]1.Between 2014-2018,693 patients were diagnosed with PTE,134 patients(19.33%)were with the aged between 14-40,and 120 patients who met the inclusion criteria,including 75 males and 45 females,with a male to female ratio of 1.67:1,mean age(31.83±6.8)years old.Among them,117 cases were diagnosed by CTPA,and 3 cases were diagnosed by echocardiography.2.The major risk factors of PTE patients in young adults were:lower extremity deep venous thrombosis 45.83%,smoking 41.67%,surgery 26.67%,and obesity 25%.The unique risk factors for women are cesarean section 7.5%,oral contraceptive 2.5%,and pregnancy 1.67%.13 patients(10.83%)out of the 120patients found no risk factors mentioned above.3.The main clinical symptoms of young PTE patients are 47.50%of chest pain,43.33%of dyspnea,34.17%of hemoptysis,10.83%of palpitations,1.67%of syncope and irritability,while typical triads with chest pain,hemoptysis and dyspnea is only 13.33%.Common positive signs are 61.67%fine wet voices of lungs,54.17%of shortness of breath,30%of fever and tachycardia,19%of purpura,18.33%of pleural effusion,and swelling of lower limbs(both deep vein thrombosis of lower limbs)10%.4.Plasma D-dimer was positive in 113 cases(94.17%)and 24 cases with,a positive CA125(32.88%);hypoxemia were found in 36 cases(30%);ST-T abnormalities were showed in 18 cases(15%);Echocardiography showed 16 cases of pulmonary hypertension(13.33%).[Conclusion]1.DVT of the lower extremities is the most common risk factor for the young patient with PTE,followed by smoking,surgery/trauma,and obesity.Caesarean section and pregnancy are important risk factors for young women with PTE.There are still 13 patients(10.83%)were found with none of the above risk factors.2.The clinical manifestations of young PTE patients are lack of specificity.Chest pain and fine wet voice of lung are the most common clinical manifestations in this study,while the typical triad with chest pain,hemoptysis,dyspnea is only 13.33%.3.One-third of young PTE patients have elevated tumor markers,whether they have clinical significance is look forward to further follow-up studies. |
PDF Full Text Request