摘要
目的 回顾性验证 Padua风险评估模型在呼吸内科住院患者中筛选静脉血栓栓塞症（VT E）的有效性.方法 采用回顾性病例对照研究方法,以2013年1月至2016年12月在广州医科大学附属第一医院呼吸内科住院患者中确诊的320例VTE患者作为VTE组,以随机数字表法选取同时期呼吸内科出院诊断非V T E的640例患者为对照组,回顾性收集2组患者病史、实验室检查结果等临床资料,并根据Padua风险评估模型进行评分.比较2组Padua评分情况并分析各危险因素与V T E发生的风险关系.结果 V T E组患者 Padua评分显著高于对照组[（3.07 ± 1.93）分 比（1.32 ± 1.53）分,t =15.304,P 〈0.05].经Padua风险评估模型判定为V T E高危患者发生V T E的风险是低危患者的11.40倍（95% C I：7.81～16.64,P 〈0.05）.进一步将Padua风险评估模型中的危险因素作为自变量进行logistic回归分析显示：已知的血栓形成倾向、VTE病史是呼吸内科患者发生VTE的主要危险因素,通过既往病史发现慢性阻塞性肺疾病急性加重期、下肢静脉曲张也是呼吸内科患者发生V T E的危险因素.结论 Padua风险评估模型可有效地基于个体危险因素对呼吸内科住院患者进行量化的VTE风险评估.
Objective To test the validity of Padua risk assessment model in identifying high venous thromboembolism （VTE） risk patients among hospitalized patients in the department of respiratory medicine.Methods A retrospective case-control study was performed among hospitalized patients in the department of respiratory medicine admitted into The First Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2016.A total of 320 patients with definite VTE during hospitalization were recruited and a total of 640 controls were randomly selected from the patients without VTE admitted into the same department within the same period.The medical history, laboratory examination results and other clinical data of two groups were retrospectively collected and the risks of both groups were retrospectively assessed with the Padua risk assessment model.The scores of both groups were compared and the realtionship of VTE and different risk factors was analyzed.Results Padua risk score in cases with VTE was significant higher than that in controls （3.07 ± 1.93 vs 1.32 ± 1.53,t =15.304,P 〈0.05）.Compared with low-risk patients by Padua assessment model,those with high risk were associated with 11.40-fold increased risk of VTE （95% CI：7.81-16.64, P 〈 0.05）. Further analysis showed that already known thrombophilic condition and previous VTE were the key risk factors of VTE,acute exacerbation of chronic obstructive pulmonary disease and varicose veins of the lower extremities were also the main risk factors of VTE.Conclusions Padua risk assessment model can effectively and quantitatively assess the risk of VTE among hospitalized patients in the department of respiratory medicine based on their individual VTE risk factors.
作者
刘恒
刘春丽
卿思敏
张笋
王静
苏小芬
张挪富
Liu Heng, Liu Chunli, Qing Simin, Zhang Sun, Wang Jing, Su Xiaofen, Zhang Nuofu.(The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou 510120, Chin)
出处
《国际呼吸杂志》
2018年第8期590-593,共4页
International Journal of Respiration
关键词
Padua风险评估模型
呼吸内科
静脉血栓栓塞症
病例对照研究
Padua risk assessment model
Department of respiratory medicine
Venous thromboembolism
Case-control studies
