摘要
目的探讨艾滋病(AIDS)合并肺栓塞(PE)患者的临床特点,以提高对该疾病的认识和诊治水平。方法对6例艾滋病合并肺栓塞患者的临床资料进行回顾性分析。结果 6例中男、女患者各3例,年龄21～64岁,平均(47±17)岁,临床表现主要为气短、咳嗽、发热,合并下肢深静脉血栓(DVT)5例,血气分析中均提示低氧血症,部分存在低CO_2血症。6例患者D-二聚体均有不同程度升高。仅1例患者存在肌钙蛋白I及脑钠肽(BNP)水平升高。其中5例予低分子肝素桥接华法林抗凝治疗,1例予新型口服抗凝药及下腔静脉滤器置入治疗,6例患者均好转出院。结论艾滋病患者发生肺栓塞时临床表现多不典型,临床上应提高对艾滋病患者合并肺栓塞的认识,对有肺栓塞危险因素的艾滋病患者提高警惕,以减少漏诊及误诊。
Objective To investigate the clinical characteristics of AIDS complicated with pulmonary embolism(PE). Method A total of 6 AIDS patients complicated with PE admitted to our hospital from May 2008 to May 2018 were retrospectively reviewed. Result There were 3 males and 3 females, with an average age of(47±17) years(range, 21~64 years). The main clinical symptom were dyspnea, cough and fever. 5 cases were complicated with lower limb deep vein thrombosis(DVT). Blood gas analysis showed low arterial partial pressure of oxygen, with or without low arterial partial pressure of carbon dioxide. All of the patients had increased level of D-Dimer and only one patient had increased levels of BNP and CTNI. 5 cases received low molecular weight heparin( LMWH) bridging anticoagulation with warfarin therapy,1 patients received anticoagulation therapy of rivaroxaban and retrievable filter was placed in the inferior vena cava(IVC). All of the patients were relieved after therapy. Conclusion These patients did not have typical clinical features of PE. It is necessary to pay attention to AIDS patients who have risk factors of PE due to its fatal outcome.
作者
赵雯
王宇
汤艳芬
陈奇
刘刚
任爱民
ZHAO Wen;WANG Yu;TANG Yan-fen;CHEN Qi;LIU Gang;REN Ai-min(Department of Respiratory Medicine,Beijing Ditan Hospital,Capital Medical University,National Clinical Key Department of Infectious Diseases,Beifing 100015,China)
出处
《中国临床医生杂志》
2018年第12期1410-1413,共4页
Chinese Journal For Clinicians
