Objective To investigate the risk factors,characteristics and prognosis in Tibetan patients with venous thromboembolism.
Methods Tibetan patients with VTE from plateau area,admitted in West China Hospital from January 2010 to December 2012,were recruited in the study. The VTE diagnosis was confirmed by CT pulmonary angiogram (CTPA) or vascular ultrasound examination. Risk factors,clinical symptoms,signs and laboratory tests were retrospectively investigated and follow-up by telephone interview was conducted.
Results 31 Tibetan VTE patients with 16 males and 15 females were included. The investigation of risk factors revealed that 15 patients suffered from obese(48.3%),10 patients suffered from highly viscous hyperlipidemia(32.3%). The most common clinical symptom was dyspnea(29%),followed by chest pain(19.4%),hemoptysis(16.1%) and cough(12.9%). The common signs were lower extremity edema(73.3%) and lung rale(36.7%). All the patients received anticoagulation therapy,and inferior vena caval filters were implanted in 2 patients. In two years' follow-up after discharge,2 patients died of tumor,2 died of pulmonary embolism,6 patients suffered from chronic embolization syndrome with lower extremity edema or pain,1 patient suffered from pulmonary hypertension after embolization,and thrombus in 20 patients disappeared or recanalized.
Conclusion Tibetans long-termly reside in high altitude areas with the eating habits of high-fat diet,which may increase the incidence of acquired risk factors such as viscous hyperlipidemia and obesity. There are no specific clinical symptoms and signs among Tibetan VTE patients,with dyspnea as the most common symptom and lower extremity edema as the most common sign. Patients with risk factors which can be eliminated in a short term have better prognosis.
Citation:
Li Huawei, Zhou Haixia, Shen Yongchun, Yi Qun, Yang Jing, Wang Bo, Wang Xiaoqing. Clinical Analysis of 31 Tibetan Patients with Venous Thromboembolism. Chinese Journal of Respiratory and Critical Care Medicine, 2013, 12(2): 198-202. doi: 10.7507/1671-6205.2014047
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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- 1. Schulman S.Advances in the management of venous thromboembolism.Best Pract Res Clin Haematol,2012,25:361-377.
- 2. Wolfe TR.Allen TL.Syncope as an emergency department presentation of pulmonary embolism.J Emerg Med,1998,16:27-31.
- 3. Anderson FA Jr,Spencer FA.Risk factors for venous thromboembolism.Circulation,2003,107(23 Suppl 1):I9-I16.
- 4. Allman-Farinelli MA.Obesity and venous thrombosis: a review.Semin Thromb Hemost,2011,37:903-907.
- 5. Zhou HX,Peng LQ,Yan Y,et al.Validation of the Caprini risk assessment model in Chinese hospitalized patients with venous thromboembolism.Thromb Res,2012,130:735-740.
- 6. Holst AG,Jensen G,Prescott E.Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study.Circulation,2010,121:1896-1903.
- 7. 王伦.四川高原藏区成人血常规正常参考值范围调查.中华检验医学杂志,2006,29:501.
- 8. Braekkan SK,Mathiesen EB,Njølstad I,et al.Hematocrit and risk of venous thromboembolism in a general population.The Tromso study.Haematologica,2010,95:270-275.
- 9. Arcelus JI,Caprini JA,Monreal M,et al.The management and outcome of acute venous thromboembolism: a prospective registry including 4011 patients.J Vasc Surg,2003,38:916-922.
- 10. 陈起航.CT肺动脉造影在肺栓塞诊断中的应用评价.中华医学杂志,2012,92:1810-1812.
- 11. 朱铁楠.D-二聚体检测在静脉血栓栓塞性疾病诊治中的应用.中华内科杂志,2012,51:240-242.
- 12. 张蔚,梁瑛,杨京华,等.心电图评分在急性肺血栓栓塞症严重程度评估中的应用.临床肺科杂志,2009,14:580-583.
- 13. Koitabashi N,Toyama T,Hoshizaki H,et al.Electrocardiographic findings in pulmonary thromboembolism--comparison with lung perfusion scan and echocardiographic findings.Kaku Igaku,2000,37:645-651.
- 14. Moya A,Sutton R,Ammirati F,et al.Guidelines for the diagnosis and management of syncope (version 2009).Eur Heart J,2009,30:2631-2671.