Objective: To compare the differences of risk factors and prognosis of pulmonary embolism (PE) between the Tibetans and the Hans. Methods: Patients over 18 years old with confirmed PE and complete clinical data from West China Hospital of Sichuan University from January 2010 to January 2016 were prospectively enrolled and divided into Tibetan group and Han group. Clinical data were collected to compare risk factors and short-term prognosis between Han group and Tibetan group. In addition, a 2-year follow-up was conducted among patients after discharge to investigate the long-term prognosis. Results: A total of 90 patients in Tibetan group and 626 patients in Han group were finally included in this study. Patients in Tibetan group were younger than Han group [(52.2±15.8) vs (59.8±16.6) years old, P<0.001], and the proportion of elderly patients (age ≥70 years) in Tibetan group was significantly lower than that of Han group (15.6% vs 33.7%, P=0.001). The hemoglobin, hematocrit, platelet counts and fibrinogen in Tibetan group were higher than those in Han group [(134.0±32.0) vs (122.2±25.7) g/L, (41.2±9.2)% vs (37.6±7.3)% and (222.2±97.5)×10(9)/L vs (187.5±87.2)×10(9)/L, 3.71(2.51, 4.89) vs 3.31(2.44, 4.42) g/L; P<0.001, <0.001 and P=0.001, 0.048, respectively]. Malignancy and chronic obstructive pulmonary disease were more common in Han group (P=0.011, 0.001), while prior venous thromboembolism history, pregnancy or a history delivery within 1 month were more common in Tibetan group (P=0.041, 0.001). Both short-term and long-term mortality in Tibetan group were significantly lower than that in Han group (2.2% vs 11.5%, 13.6% vs 24.9%; P=0.005, 0.020). Conclusions: Hypercoagulable state plays an important role in the pathogenesis of PE in Tibetan patients. Both short-term and long-term prognosis of PE in Tibetan patients are better than that in Han patients.
目的： 比较藏族与汉族肺栓塞患者的危险因素及预后差异。 方法： 纳入2010年1月至2016年1月四川大学华西医院确诊的年龄>18岁且临床资料齐全的藏族和汉族肺栓塞患者，分别作为藏族组及汉族组。在患者出院时分析其临床资料，比较两组患者肺栓塞危险因素的分布和短期预后差异；出院后通过电话随访2年以获得两组患者的长期预后信息并进行比较分析。 结果： 共纳入符合要求的藏族组90例，汉族组626例。藏族组年龄显著小于汉族组[(52.2±15.8)比(59.8±16.6)岁；P<0.001]，且藏族组高龄患者(年龄≥70岁)比例显著低于汉族组(15.6%比33.7%，P＝0.001)。藏族组静脉血血红蛋白含量、血细胞比容和血小板计数、纤维蛋白原含量均显著高于汉族组[(134.0±32.0)比(122.2±25.7)g/L、(41.2±9.2)%比(37.6±7.3)%和(222.2±97.5)比(187.5±87.2)×10(9)个/L、3.71(2.51，4.89)比3.31(2.44，4.42)g/L；分别P<0.001、<0.001和P＝0.001、0.048]。汉族组现患慢性阻塞性肺疾病、现患恶性肿瘤更常见(P＝0.011、0.001)，而藏族组既往静脉血栓栓塞症、妊娠或既往1个月内分娩史更常见(P＝0.041、0.001)。藏族组短期病死率及2年病死率均显著低于汉族组(2.2%比11.5%，13.6%比24.9%；P＝0.005、0.020)。 结论： 血液高凝状态在藏族患者肺栓塞发病中起了重要作用。藏族肺栓塞患者的短期及长期预后均优于汉族患者。.
Keywords: Han nationality; Prognosis; Pulmonary embolism; Risk factors; Tibetan nationality.