摘要
目的探讨下肢深静脉血栓形成后发生肺栓塞的危险因素。方法本研究采用回顾性研究方法,收集2016年1月至2018年1月就诊安徽医科大学第二附属医院确诊为下肢深静脉血栓患者的资料,其中符合纳入标准的共有142例患者,采用Logistic回归分析探寻下肢深静脉形成后发生肺栓塞的危险因素。结果 142例下肢深静脉血栓形成患者,其中有56例发生肺栓塞,通过统计分析发现:合并存在外伤手术史(OR=4.36,95%CI 1.38-13.82,P=0.01);冠心病(OR=17.41,95%CI 3.49-86.90,P<0.01);高血压(OR=26.69,95%CI 6.68-106.62,P<0.01);心脏瓣膜病(OR=4.00,95%CI 1.01-15.83,P=0.04);慢性肺部疾病(OR=2.57,95%CI 0.51-12.92,P=0.03);恶性肿瘤病史(OR=7.38,95%CI 0.90-60.22,P=0.04);D-D(OR=1.10,95%CI 0.99-1.11,P=0.02)与下肢深静脉血栓形成患者发生肺栓塞密切相关,通过t检验,发现Wells评分(t=-10.84,P<0.01)升高会增加发生肺栓塞的风险。结论下肢深静脉血栓形成的患者合并外伤手术史、慢性心血管疾病(包括冠心病、高血压、心脏瓣膜病)、慢性肺部疾病、恶性肿瘤病史是发生肺栓塞的高危因素;D-D、Wells评分升高是会增加肺栓塞的风险。
Objective To investigate the risk factors of pulmonary embolism after deep vein thrombosis in lower extremities. Methods In this study, a retrospective study was used to collect data from the Second Affiliated Hospital of Anhui Medical University from January 2016 to January 2018, which was diagnosed as deep vein thrombosis. A total of 142 patients were conformed to the standard. The risk factors of pulmonary embolism after deep vein formation of lower extremities were analyzed by Logistic regression analysis. Results In 142 patients with deep venous thrombosis of lower limbs, 56 of them had pulmonary embolism. Through statistical analysis, the incidence of pulmonary embolism after deep vein thrombosis in lower extremities was closely correlated with history of traumatic surgery (OR=4.36, 95%CI 1.38-13.82, P =0.01), coronary heart disease ( OR=17.41, 95%CI 3.49-86.90, P< 0.01), hypertension (OR=25.84, 95%CI 7.97-83.80, P< 0.01), heart valvular disease (OR=4.00, 95%CI 1.01-15.83, P =0.04), chronic pulmonary disease ( OR=2.57, 95%CI 0.51-12.92, P =0.03), history of malignant tumor ( OR=7.38, 95%CI 0.90-60.22,P =0.04) and D-D ( OR=1.10, 95%CI 0.99-1.11, P =0.02). The increase of Wells score ( t=-10.84, P< 0.01) was the risk factor of pulmonary embolism found by t test. Conclusion The history of trauma surgery, chronic cardiovascular disease (including coronary heart disease, hypertension, heart valvular disease), chronic pulmonary disease, and the history of malignant tumor are the high risk factors for pulmonary embolism in patients with deep venous thrombosis of lower extremities. The high levels of D-D and Wells score can increase the risk of adding pulmonary embolism.
作者
张毅
赵卉
刘云峰
陈玲玉
ZHANG Yi;ZHAO Hui;LIU Yun-feng;CHEN Ling-yu(Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China)
出处
《临床肺科杂志》
2019年第5期790-793,共4页
Journal of Clinical Pulmonary Medicine
基金
国家自然科学基金(No 81670060)
安徽省自然科学基金(No 1508085MH192)
关键词
下肢深静脉血栓形成
肺栓塞
危险因素
deep venous thrombosis of lower extremities
pulmonary embolism
risk factors
