Correlation Study Of Pulmonary Thromboembolism And The Levels Of Serum Lipid

[Objective] To explore the clinical features of pulmonarythromboembolism (PTE) patients with different embolization area, and studythe correlation between PTE and the levels of serum lipid. In order to evaluatethe value that the levels of serum lipid forecast the onset of PTE, and explorethe risk factors of PTE in lipid metabolism, and clear part of the reasons aboutthe onset of PTE.[Methods] The demographic data, clinical history data and thelaboratory results including the levels of serum lipid were reviewed for102patients with PTE from January2002and December2011in TongjiUniversity affiliated to Shanghai Pulmonary Hospital. According to thediagnosis standard massive PTE or submassive PTE are group A,non-massive PTE are group B.63healthy volunteers exclude PTE or deepvein thrombosis (DVT) history are control group.[Results](1) In the demographic data, clinical history data, gender and age weresignificant differences between group A and group B (P <0.05). Male, age (≥65years) in group A, are higher than group B. There was significantdifference between the two groups whether with DVT (P <0.01). Otherfactors were no significant differences.(2) In PTE patients, dyspnea (>80%), chest pain, cough were commonsymptoms, dyspnea, chest pain, haemoptysis occur at the same were rare, theincidence was less than20%. The incidence of palpitations, syncope, feelingof impending death in PTE patients between group A and group B were68.75%vs38.57%,4.63%vs18.57%,40.63%vs21.43%, there weresignificant differences between the two groups (P <0.05).(3) Respiratory frequency, accentuation of P2were the most commonsigns of PTE patients, there were no significant difference between group Aand group B (P>0.05). The incidence of tachycardia, elevated neck veins ingroup A and group B were53.13%vs24.29%,40.63vs21.43%, there weresignificant differences between the two groups (P <0.05).(4) Total cholesterol (TC), triglycerides (TG), high-density lipoproteincholesterol (HDL), apolipoprotein AⅠ(apoAⅠ), apolipoprotein B (apoB) inPTE group, were higher than control group(P <0.05), high-densitylipoprotein cholesterol (HDL) was lower in PTE group than control group(P<0.05). In PTE patients, TG (1.63±0.65mmol/L) in group A was higherthan group B (1.35±0.67mmol/L), HDL (0.99±0.23mmol/L) in group A waslower than group B (1.16±0.18mmol/L), there were significant differences (P<0.05). TC, LDL, apoAⅠ, apoB were no significant differences betweengroup A and group B (P>0.05).(5) A stepwise logistic regression analysis was performed that PTE isnegatively correlated with the level of HDL (r=-0.384, P<0.001). HDL<1.01mmol/L was the independent risk factor that determined the magnitude ofembolism area, with a sensitivity of0.828and specificity of0.656.[Conclusions] Male, elder, with DVT are the risk factors of massivePTE or submassive PTE. When PTE patients emerge palpitation, syncope,feeling of impending death, tachycardia, elevated neck veins were a clue ofmassive PTE or submassive PTE. Except other factors, PTE is negativelycorrelated with the level of HDL. HDL is the sensitive index to forecast theonset of massive PTE or subassive PTE.