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目的:探讨血清同型半胱氨酸(Hcy)水平与急性肺栓塞患者发生死亡的关系。方法:回顾性分析2009年8月至2012年8月期间于我院收治的200例急性肺栓塞患者的临床与检验资料,并根据血清Hcy水平分为105例高Hcy水平组(Hcy≥15.31μmol/L)与95例低Hcy水平组(Hcy<15.31μmol/L)。对比两组患者的基线特征,并采用Cox比例危险模型对Hcy水平与急性肺栓塞患者发生死亡的关系进行判断。结果:在随访期间内,共40例(20.00%)患者发生死亡,高Hcy水平组患者的死亡率为30.48%,显著高于低Hcy水平组的8.42%,且两组患者在入院时的氧饱和度、心率、收缩压、年龄、肌酐水平、肌钙蛋白T峰值、深静脉血栓史等对比,差异均存在统计学意义(P<0.05);经单因素筛选及多因素分析后,Hcy≥15.31μmol/L、深静脉血栓以及心率等均是影响患者发生死亡的独立危险因素(P<0.05)。结论:高血清Hcy水平与急性肺栓塞患者发生死亡具有显著相关性,可作为预测该疾病患者死亡的独立因子,应引起临床重视。
Objective: To investigate the relationship between serum homocysteine (Hcy) level and mortality in patients with acute pulmonary embolism. Methods: The clinical and laboratory data of 200 patients with acute pulmonary embolism admitted to our hospital from August 2009 to August 2012 were retrospectively analyzed. According to the serum Hcy level, 105 patients with high Hcy level (Hcy≥15.31μmol / L) and 95 patients with low Hcy (Hcy <15.31μmol / L). The baseline characteristics of the two groups of patients were compared and the relationship between Hcy levels and death in patients with acute pulmonary embolism was assessed using the Cox proportional hazards model. Results: A total of 40 patients (20.00%) died during the follow-up period. The mortality rate of high Hcy group was 30.48%, which was significantly higher than that of low Hcy group (8.42%), and oxygen (P <0.05). After single-factor screening and multivariate analysis, Hcy ≥ 15.31μmol / L, deep venous thrombosis and heart rate were all the independent risk factors affecting the death of patients (P <0.05). Conclusion: There is a significant correlation between the serum Hcy level and the death of patients with acute pulmonary embolism. It may be used as an independent factor to predict the death of patients with this disease and should be clinically valued.