摘要
背景脑卒中患者是下肢深静脉血栓形成(DVT)的高危人群,但脑卒中患者下肢DVT的影响因素尚未完全明确。目的探讨脑卒中患者下肢DVT的影响因素及其干预策略。方法选取2018年3月-2019年3月在首都医科大学附属北京天坛医院确诊的脑卒中患者260例,根据随访2个月是否出现下肢DVT分为DVT组(n=42)和非DVT组(n=218)。比较两组患者一般资料〔包括年龄、性别、体质指数(BMI)、吸烟史、饮酒史、高血压病史、糖尿病病史、格拉斯哥昏迷量表(GCS)评分、Wells评分、卧床时间、下肢血管狭窄程度、介入治疗后肢体制动时间〕及实验室检查指标〔包括白蛋白、同型半胱氨酸(Hcy)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体〕。结果两组患者性别、BMI、饮酒史、高血压病史、GCS评分、下肢血管狭窄程度、白蛋白、Hcy、HDL-C、LDL-C、TC、TT、PT、APTT比较,差异无统计学意义(P>0.05);DVT组年龄≥60岁、有吸烟史、有糖尿病病史、卧床时间≥7 d、介入治疗后肢体制动时间≥1 d者所占比例及Wells评分、TG、D-二聚体高于非DVT组(P<0.05)。多因素Logistic回归分析结果显示,年龄〔OR=2.277,95%CI(1.209,3.176)〕、吸烟史〔OR=2.371,95%CI(1.226,3.014)〕、糖尿病病史〔OR=4.076,95%CI(2.087,9.191)〕、Wells评分〔OR=1.684,95%CI(1.042,5.925)〕、卧床时间〔OR=1.828,95%CI(1.015,4.607)〕、介入治疗后肢体制动时间〔OR=2.069,95%CI(1.816,7.619)〕、TG〔OR=1.675,95%CI(1.582,3.823)〕、D-二聚体〔OR=2.085,95%CI(1.805,7.808)〕是脑卒中患者下肢DVT的独立影响因素(P<0.05)。结论高龄、吸烟史、糖尿病病史、高Wells评分、长时间卧床、介入治疗后肢体制动时间长、高TG、高D-二聚体是脑卒中患者下肢DVT的独立影响因素,因此需加强脑卒中患者下�
Background Stroke patients have high influencing of lower extremity deep venous thrombosis(DVT),but influencing factors of lower extremity DVT in not yet completely clear in patients with stroke.Objective To explore the influencing factors and intervention strategy of lower extremity DVT in stroke patients.Methods A total of 260 stroke patients were selected in Beijing Tiantan Hospital,Capital Medical University from March 2018 to March 2019,and they were divided into DVT group(n=42)and non-DVT group(n=218)according to the incidence of lower extremity DVT 2 months after follow-up.General information(including age,gender,BMI,smoking history,drinking history,hypertension history,diabetes history,GCS score,Wells score,time in bed,degree of lower extremity vascular stenosis and limb braking time after interventional therapy)and laboratory examination results(including albumin,Hcy,HDL-C,LDL-C,TG,TC,TT,PT,APTT and D-dimer)were compared between the two groups.Results No statistically significant difference of gender,BMI,drinking history,hypertension history,GCS score,degree of lower extremity vascular stenosis,albumin,Hcy,HDL-C,LDL-C,TC,TT,PT or APTT was found between the two groups(P>0.05);proportion of patients≥60 years old,with smoking history,with diabetes history,with time in bed≥7 days,with limb braking time≥1 day after interventional therapy,Wells score,TG,D-dimer in DVT group was statistically significantly higher than that in non-DVT group,respectively(P<0.05).Multivariate Logistic regression analysis results showed that,age〔OR=2.277,95%CI(1.209,3.176)〕,smoking history〔OR=2.371,95%CI(1.226,3.014)〕,diabetes history〔OR=4.076,95%CI(2.087,9.191)〕,Wells score〔OR=1.684,95%CI(1.042,5.925)〕,time in bed〔OR=1.828,95%CI(1.015,4.607)〕,limb braking time after interventional therapy〔OR=2.069,95%CI(1.816,7.619)〕,TG〔OR=1.675,95%CI(1.582,3.823)〕and D-dimer〔OR=2.085,95%CI(1.805,7.808)〕were independent influencing factors of lower extremity DVT in stroke patients(P<0.05).Conclusion Advanced a
作者
周克文
武美茹
张倩
ZHOU Kewen;WU Meiru;ZHANG Qian(Neurology Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《实用心脑肺血管病杂志》
2019年第10期19-23,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家自然科学基金青年科学基金资助项目(81501001)
关键词
卒中
深静脉血栓形成
下肢
影响因素分析
干预策略
Stroke
Deep vein thrombosis
Lower extremities
Root cause analysis
Intervention strategy
