| Objective 1.To study the incidence of CTEPH after APE.2.To evaluate the percentage of patients with APE who underwent CTPA,cardiac ultrasound or RHC again after3 months.3.The possible risk factors for the development of APE to CTEPH were analyzed.Methods 1.The paper contains the cinical data of patients who suffer from APE in the General Hospital of Ningxia Medical University and Cardio-cerebrovascular Disease Hospital from June 2016 to June 2019.2.According to the imaging examination and related auxiliary examinations which more than 3 months after formal anticoagulant therapy,the patients were placed into CTEPH group and non-CTEPH group.3.To gather the two groups’ General data,laboratory examination,imaging examination and other relevant auxiliary examination data.4.Analyze whether the difference between the two groups of indicators has statistical sense,and analyze its connection with the occurrence of CTEPH.Use the SPSS21.0statistical method to analyze the data,and if P <0.05,it is believed to make sense in statistics.Results 1.From June 2016 to June 2019,a total of 1638 patients with APE were admitted to General Hospital of Ningxia Medical University and Cardio-cerebrovascular Disease Hospital,and 637 of them received conventional anticoagulant therapy and reexamination of CTPA,UCG or RHC 3 months later.To rule out severe COPD and pulmonary heart disease,congenital heart disease,tuberculosis damage to the lung which lead to PH,157 cases were repeatedly identified and the results of the APE study in 480 cases were as low risk 253(52.7%),moderate 181(37.7%),and high risk 46(9.6%).39 patients(8.1%)met the diagnostic criteria for CTEPH.Thirty-nine patients(8.1%)met the diagnostic criteria for CTEPH,including 12 patients(30.8%)with low risk,20 patients(51.3%)with moderate risk,and 7 patients(17.9%)with high risk.2.General data: The age of CTEPH group was significantly higher than that of non-CTEPH group(68.4±14.3 vs 61.5±13.6,Z =-3.199,P =0.001).The risk stratification of pulmonary embolism in CTEPH group was higher than that in non-CTEPH group(Z =-3.000,P = 0.003).sPESI score of the two groups did the same as the age of two groups(Z =-2.913,P =0.004).Serum brain natriuretic peptide did the same as the above date(Z =-4.042,P=0.000).On the basis of the above statistical results,there were statistically significant differences in age,pulmonary embolism risk stratification,sPESI score and brain natriuretic peptide between the two groups.It did not have significant differences between the two groups in gender,ethnicity,adequacy of treatment,treatment method,duration of follow-up,troponin,CKMB,myoglobin and other aspects.3.The above indicators with statistical differences were incorporated into the Logistic regression analysis of the dichotomous response variables,and the results indicated that age,pulmonary embolism risk stratification and brain natriuretic peptide were the risk factors for CTEPH after APE.4.The reexamination rate of CTPA,UCG or RHC after 3 months of APE treatment was about 38.89%,A total of 480 patients were included according to the inclusion criteria and exclusion criteria,of which 5 cases were reexamined for RHC,accounting for 1.0%,and all had residual thrombosis.There were 360 patients with CTPA reexamination,accounting for75%,among which 55 patients had residual thrombosis.At the same time,34 patients with pulmonary hypertension were confirmed by heart color ultrasound,and 21 patients with no signs of pulmonary hypertension were considered as CTED.Conclusion The incidence of CTEPH after APE in our hospital is high,high risk stratification of pulmonary embolism,advanced age and high brain natriuretic peptide are risk factors for CTEPH,and the reexamination rate of APE patients after 3 months is low,The level of diagnosis and treatment of CTEPH by clinicians should be enhanced,and the awareness rate of patients’ health education should be improved. |
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