老年肺血栓栓塞症的特点和临床诊治思路

Characteristics of pulmonary thromboembolism in the elderly and thought of its diagnosis and treatment

摘要:

老年人群是肺血栓栓塞症（PTE）的高危人群，有研究显示随着年龄增长，PTE的发病率呈现升高趋势，且老年PTE的病死率、复发率和出血发生率较年轻人明显升高。 因此，老年PTE作为一个重要的国际性医疗保健问题已引起各国普遍关注。在过去的20年间，老年PTE的诊断和治疗取得了很大进步，如新的诊断策略的建立（包括Wells评分和改良的Geneva评分）、年龄调整的D?二聚体界限值对于PTE的排除诊断价值、新型抗凝药物在老年患者中的应用等。本文我们主要针对老年PTE诊断治疗方面的最新进展进行了总结，以期对临床肺血管病医师有所帮助。

Abstract:

The elderly are at high risk for pulmonary thromboembolism (PTE). Evidence shows that the prevalence of PTE is increased during aging, and its mortality, recurrence and hemorrhage rate are extremely high in the elderly than in the young people. Therefore, as an important global health issue, the elderly PTE draws attention from clinicians all over the world. In the past 2 decades, great progress has been achieved in the diagnosis and treatment of elderly PTE, including the establishment of new diagnostic strategy (Wells score and modified Geneva score), the application of age-adjusted D-dimer cutoff levels for excluding PTE, the use of new oral anticoagulants for older patients, etc. In this article, we mainly summarized the progress in the diagnosis and treatment of PTE and hoped this would be helpful to Chinese pulmonary vascular clinicians.