摘要
目的 通过分析老年静脉血栓栓塞症(VTE)患者的临床特点,并探讨其预后影响因素。方法 回顾性分析2018年5月至2019年12月在中国医科大学附属第一医院老年医学科住院治疗的诊断VTE的患者101例,按VTE类型分为深静脉血栓形成(DVT)组80例和肺栓塞组21例,分析患者的临床特点,同时进行多因素logistic回归分析老年VTE预后的影响因素。结果 肺栓塞组COPD、呼吸衰竭比例及利尿剂使用率明显高于DVT组(28.6%vs 10.0%,P=0.028;57.1%vs 16.3%,P=0.000;42.9%vs 21.3%,P=0.044)。多因素回归logistic分析显示,高白蛋白和抗凝治疗是VTE预后的保护因素(P<0.05,P<0.01),BNP升高和呼吸衰竭是VTE预后不良的独立危险因素(P<0.05)。结论 老年VTE患者躯体功能差、营养状态差、共病状态,易漏诊。抗凝治疗可以明显改善老年患者预后,但需要个体化治疗。
Objective To explore the prognostic factors of venous thromboembolism(VTE)in elderly patients by analyzing their clinical features.Methods A retrospectively study was carried on 101elderly VTE patients admitted in our department from May 2018to Dec 2019.All patients were divided into DVT group(80cases)and PE group(21cases).Clinical characteristics were analyzed for these patients.Logistic regression analysis was conducted to evaluate prognostic factors.Results The proportions of COPD,respiratory failure and usage of diuretics was significantly higher in the PE group than the DVT group(28.6%vs 10.0%,P=0.028;57.1%vs 16.3%,P=0.000;42.9%vs 21.2%,P=0.044).Multivariate logistic regression analysis indicated that high serum albumin level and anticoagulation therapy were protective factors for VTE prognosis(P<0.05,P<0.01),and high BNP level and respiratory failure were independent risk factors for poor prognosis of VTE(P<0.05).Conclusion Elderly VTE patients have poor physical function,nutritional status and comorbidity,and missed diagnosis is common.Anticoagulation therapy can obviously improve prognosis,but individualized treatment is needed in elderly patients.
作者
关晴
余陆娇
张海燕
康可歆
Guan Qing;Yu Lujiao;Zhang Haiyan;Kang Kexin(Department of Geriatrics,the First Hospital of China Medical University,Shenyang,110001,Liaoning Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第4期386-389,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
辽宁省重点研发计划“医学科技成果转化专项”[辽科发(2019)24号]。
关键词
静脉血栓栓塞
预后
危险因素
回归分析
venous thromboembolism
prognosis
risk factors
regression analysis
