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北京京煤集团总医院 第十届·2022 学术年会论文集
煤工尘肺患者合并静脉血栓栓塞症的危险因素分析
化静，陈亮，张建红，石金凤，李瑶（北京京煤集团总医院呼吸与危重症医学科）
【摘要】目的： 研究煤工尘肺患者合并静脉血栓栓塞症 (VTE) 的临床危险因素，以便于更
早地发现煤工尘肺合并 VTE。方法：对 2017 年 1 月-- 2019 年 12 月北京京煤集团总医院收
治的 156 例煤工尘肺患者，均完善螺旋 CT 肺动脉造影（CT pulmonary angiography CTPA）
及下肢静脉超声检查，根据检查结果分为煤工尘肺组和煤工尘肺+VTE 组，比较两组患者在
发生 VTE 的一般资料、体征以及实验室检查结果的差异，采用单因素和多因素 logistic 回归
分析探索煤工尘肺+VTE 发病相关危险因素。 结果：156 煤工尘肺患者中，32 例 （ 20.51%）
合并 VTE，124 例 （ 79.48%）煤工尘肺患者未合并 VTE，两组危险因素有统计学差异的有：
既往血栓病史、制动/卧床时间≥3 天、下肢不对称水肿、D-二聚体、BNP 水平。多因素 logistic
回归分析显示，既往血栓病史、制动/卧床时间≥3天、不对称下肢水肿及D-二聚体≥1500ng/ml、
BNP≥1200Pg/ml 为煤工尘肺合并 VTE 的危险因素。 结论: 煤工尘肺患者合并 VTE 的发生
率为 20.92%，多因素共同参与煤工尘肺合并 VTE 的发生，临床上既往血栓病史、制动或卧
床≥3 天、下肢不对称水肿及 D-二聚体、BNP 水平升高时，尽快完善相关检查明确是否伴有
VTE。
【关键词】静脉血栓栓塞；煤工尘肺；危险因素
[Abstract] Objective: The study aims to explore the clinical risk factors of patients with coal
worker's pneumoconiosis complicated with venous thromboembolism (VTE), in order to detect coal
worker's pneumoconiosis complicated with VTE earlier. Methods: CT pulmonary angiography
CTPA and lower limb venous ultrasonography were performed for 156 patients with coal worker's
pneumoconiosis treated in Beijing Jingmay Group General Hospital from January 2017 to
December 2019. According to the results of examinations, patients were divided into the coal
worker's pneumoconiosis group and the coal worker's pneumoconiosis +VTE group. The general
information, physical signs and laboratory examination results of patients were compared between
the two groups, and univariate and multivariate logistic regression analysis were conducted to
explore the risk factors related to the incidence of coal worker's pneumoconiosis +VTE. Results:
Among 156 patients with coal worker's pneumoconiosis, 32 cases (20.51%) were complicated with
VTE, and 124 cases (79.48%) were not complicated with VTE. There were statistically significant
differences in risk factors between the two groups: Previous history of thrombosis, duration of
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