2025 年第 10 期 第 20 卷

癌症合并急性肺栓塞的临床特征分析

Analysis of clinical characteristics of cancer patients with acute pulmonary embolism

作者：臧文倩高鹏飞王伟陈博胡锦锦李恒赟毛毅敏

英文作者：Zang Wenqian Gao Pengfei Wang Wei Chen Bo Hu Jinjin Li Hengyun Mao Yimin

单位：河南科技大学第一附属医院河南科技大学临床医学院呼吸与危重症医学科，洛阳471003

英文单位：Department of Respiratory and Critical Care Medicine the First Affiliated Hospital of Henan University of Science & Technology College of Clinical Medicine of Henan University of Science & Technology Luoyang 471003 China

关键词：急性肺栓塞；癌症；临床特征；住院结局

英文关键词：Acutepulmonaryembolism;Cancer;Clinicalcharacteristics;In-hospitaloutcomes

• 摘要：

• 目的 分析因急性肺栓塞而入住医院的患者，描述有癌症或无癌症患者的临床特征和住院结局。方法 回顾性分析2011年7月至2023年2月河南科技大学第一附属医院收治的1 931例明确诊断急性肺栓塞患者的临床资料，根据是否合并癌症分为癌症组（307例）和无癌症组（1 624例）。比较2组的临床特征和住院结局。结果 癌症组呼吸困难、胸痛、晕厥、发热症状比例均低于无癌症组（均P＜0.05），癌症组无临床症状比例（19.9%）约为无癌症组（7.4%）的3倍（P＜0.001）。在肺栓塞欧洲心脏病学会风险分层方面，2组之间的高危占比差异无统计学意义（P=0.214）。2组国际标准化比值、凝血酶原时间比值、凝血酶原活动度、凝血酶原时间和纤维蛋白原差异均有统计学意义（均P＜0.05）。癌症组预测住院死亡率为14.7%（45/307），无癌症组为8.3%（135/1 624），组间差异有统计学意义（χ2=12.298，P＜0.001）。结论 癌症组中无临床症状的比例大约是无癌症组的3倍，除了更严重的高凝状态，无临床症状可能是不良预后的重要原因。

• Objective To analyze patients admitted to the hospital for acute pulmonary embolism, and to describe the clinical characteristics and in-hospital outcomes of patients with or without cancer. Methods The clinical data of 1 931 patients with acute pulmonary embolism admitted to the First Affiliated Hospital of Henan University of Science & Technology from July 2011 to February 2023 were retrospectively analyzed. According to the presence or absence of cancer, they were divided into cancer group (307 cases) and non-cancer group (1 624 cases). Clinical characteristics and in-hospital outcomes were compared between the two groups. Results The proportions of dyspnea, chest pain, syncope and fever in the cancer group were lower than those in the non-cancer group (all P＜0.05). The proportion of patients without clinical symptoms in the cancer group (19.9%) was about three times higher than that in the non-cancer group (7.4%, P＜0.001). In terms of European Society of Cardiology risk stratification of pulmonary embolism, there was no significant difference in the proportion of high risk between the two groups (P=0.214). There were significant differences in international normalized ratio, prothrombin time ratio, prothrombin activity, prothrombin time and fibrinogen between the two groups (all P<0.05). The predicted in-hospital mortality was 14.7% (45/307) in cancer group and 8.3% (135/1 624) in non-cancer group, and the difference between the two groups was statistically significant (χ2=12.298, P＜0.001). Conclusions The proportion of patients with no clinical symptoms in the cancer group was approximately three times higher than that in the non-cancer group, and in addition to a more severe hypercoagulable state, the absence of clinical symptoms may be an important cause of poor prognosis.