心血管疾患に伴う急性肺血栓塞栓症の臨床的凝血学的検討

概要

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The clinical profiles of 55 patients with acute pulmonary thromboembolism (A-PTE) with cardiovascular disease were analyzed. Various parameters of coagulation and fibrinolysis were measured in order to evaluate their role in the diagnosis and treatment of A-PTE. The most common symptoms of A-PTE were dyspnea and chest pain. ECG showed tachycardia in 69% of the patients. SIQIIITIII was seldom seen but negative T waves in V1～V3 were seen in 20% of the patients. Chest roentgenograms reveaeld infiltration or consolidation in 11% of patients. In 45% of the patients, however, there were no changes in chest roentgenograms. PaO_2 decreased in 91% of patients. Common coexisting conditions were immobilization, obesity and central venous and long-term in-dwelling catheters. Plasma concentrations of D-dimer, TAT F1+2 were very high, and decreased in parallel with the improvements of symptoms and lung per fusion scintigraphy (TAT, 25.3 ± 8.0→3.9 ± 0.8ng/ml, p=0.0001:F1+2, 2.1 ± 0.7→0.8 ± 0.2nM, p=0.0021 ; D-dimer, 1846 ± 536.9→377.8 ± 90.5 ng/ml, p=0.0017). These results suggest that these parameters have high diagnostic value and are useful for monitoring efficacy of treatment.
東京女子医科大学の論文
1996-12-25