肺栓塞（PE）后残留肺血管阻塞（RPVO）很常见，但其与纤维蛋白凝块特性的关系尚不清楚。我们研究了血栓前状态和纤溶低下标志物是否可以识别 RPVO 患者。在 79 名血压正常的非癌症急性 PE 患者（年龄 56±13.3 岁）中，我们测定了纤维蛋白凝块通透性 (Ks)、凝块溶解时间 (CLT)、内源性凝血酶潜力 (入院时开始抗凝治疗前、抗凝治疗 5-7 天后和 3 个月后进行 ETP）、纤溶蛋白、氧化应激标记物和 E-选择素。 PE 后 3-6 个月使用计算机断层扫描血管造影诊断 RPVO。 RPVO 患者 (n = 23, 29.1%) 在基线时具有较高的简化肺栓塞严重指数 (sPESI) (P = 0.004)、较高的 N 端脑钠尿前肽(P = 0.006) 和更高的 D-二聚体 (P = 0.044)。与无 RPVO 的患者相比，基线时和入院后 5-7 天的 Ks 较低（P<0.001），CLT 较长（P<0.05），但 3 个月时则不然。仅在 3 个月时，RPVO 患者的 E-选择素就升高了 40.6% (P<0.001)。通过多变量逻辑回归，基线 Ks（优势比 [OR] 0.010，95% 置信区间 [CI] 0.001-0.837，P = 0.042，每 10- 9 cm2），基线 D-二聚体（OR 1.105，95% CI 1.000- 1.221，P = 0.049，每 100 ng/ml）和 3 个月后 E-选择素水平（OR 3.874，95% CI 1.239-12.116，P = 0.020，每 1 ng/ml）与 RPVO 相关。抗凝的特点是入院时形成较致密的纤维蛋白凝块，并在 3 个月时形成较高的 E-选择素。这些参数可能是潜在的新 RPVO 风险因素，需要在独立队列中进行进一步评估。© 2023。作者。

Residual pulmonary vascular obstruction (RPVO) is common following pulmonary embolism (PE) but its association with fibrin clot properties is poorly understood. We investigated whether prothrombotic state and hypofibrinolysis markers can identify patients with RPVO.In 79 normotensive noncancer patients (aged 56 ± 13.3 years) with acute PE, we determined fibrin clot permeability (Ks), clot lysis time (CLT), endogenous thrombin potential (ETP), fibrinolysis proteins, oxidative stress markers, and E-selectin on admission before initiation of anticoagulant therapy, after 5-7 days, and 3 months of anticoagulation. RPVO was diagnosed using computed tomography angiography 3-6 months since PE.Patients with RPVO (n = 23, 29.1%) had at baseline higher simplified Pulmonary Embolism Severity Index (sPESI) (P = 0.004), higher N-terminal brain natriuretic propeptide (P = 0.006) and higher D-dimer (P = 0.044). Patients with versus without RPVO had lower Ks (P < 0.001) and longer CLT (P < 0.05), both at baseline and 5-7 days since admission, but not at 3 months. Patients with RPVO showed 40.6% higher E-selectin (P < 0.001) solely at 3 months. By multivariable logistic regression, baseline Ks (odds ratio [OR] 0.010, 95% confidence interval [CI] 0.001-0.837, P = 0.042, per 10- 9 cm2), baseline D-dimer (OR 1.105, 95% CI 1.000-1.221, P = 0.049, per 100 ng/ml), and E-selectin levels after 3 months (OR 3.874, 95% CI 1.239-12.116, P = 0.020, per 1 ng/ml) were associated with RPVO.RPVO patients despite anticoagulation characterize with the formation of denser fibrin clots on admission and higher E-selectin at 3 months. Those parameters could be the potential novel RPVO risk factors that warrant further evaluation in an independent cohort.© 2023. The Author(s).