摘要
目的探讨静脉血栓栓塞症（VTE）发生的高危因素及应用Caprini风险评估模型评估住院患者VTE发生风险的有效性。方法对2012年1月1日至12月31日在煤炭总医院及朝阳医院确诊为VTE的住院患者进行研究。287例符合入选条件的被纳入研究。收集患者的一般资料、VTE危险因素、相关实验室检查及影像学检查结果等。分析VTE与各危险因素之间的关系。应用Caprini风险评估模型对患者进行VTE风险评估。随访患者出院后VTE复发情况及生存状态。结果@287例患者中92例（32．1％）患者患有DVT，93例（32．4％）患者患有PTE，102例（35．5％）患者同时患有DVT及PTE；155例为内科患者，132例为外科患者。②VTE患者危险因素排在前5位的依次是：BMI〉25kg／m^2（63．2％），蛋白C或蛋白S缺乏（52．4％），血清同型半胱氨酸升高（50％），长期卧床136例（47．4％），严重肺部疾病132例（46．0％）。③与内科患者相比，Caprini模型评估外科患者VTE发生风险更为有效，且差异有统计学意义（风险评估分值内科患者为6．68±3．27，外科患者为7．84±3．45，P=0．004）。④随访中48例患者复发性VTE，复发率为18．5％。其中极高危患者的复发率最高（29．0％），其次为高危患者（6．5％），低中危患者无VTE复发。生存曲线显示，极高危患者vTE复发风险最高，且差异有统计学意义（P=0．021）。结论①住院患者VTE的高危因素包括：BMI〉25kg／m^2,蛋白C或蛋白S缺乏、血清同型半胱氨酸升高、长期卧床、严重肺部疾病。②Caprini模型评估外科患者VTE发生风险较内科患者更为有效，并且为预测VTE复发风险提供参考。
Objective To investigate the risk factors of venous thromboembolism （VTE） through analyze risk factors for patients with VTE during hospitalization. To explore the effectiveness of Caprini risk assessment model in assessing VTE risk in hospitalized patients. Methods 287 patients diagnosed as VTE during hospitalization in Meitan General Hospital and Chaoyang Hospital from January 1, 2012 to December 31, 2012 were enrolled. The general clinical data, risk factor for VTE, laboratory examination and imaging data were collected and analyzed. The relationship between VTE and risk factors was analyzed. The risk of VTE was evaluated by using the Caprini risk assessment model. The recurrence of VTE and survival states during follow-up were collected. Results （1）Of the 287 patients, 92 （32.1% ） patients with DVT, 93 （32.4%） patients with PTE, 102 （35.5%） patients with DVT and PTE. 155 were intern medicine patients, and 132 were surgical patients. （2）The risk factors of VTE in the top five were： BMI〉25 kg/m^2（63.2%）, Protein C or protein S deficiency（52.4%）, serum hyperho- mocysteinemia （50%）, long-term bed-ridden （47.4%）, severe lung disease in 132 patients （46%）. （3）Caprini model was more effective in evaluate the risk of VTE in surgery patients than medicine patients and the differences were statistically significant （average risk score, 7.84±3.45 vs. 6.68±3.27, P=0.004）. （4）48 cases were found recurrent VTE during follow-up, the recurrence rate was 18.5%. The highest （29.0%） recurrence rate occurred in very high-risk patients, secondly was in high-risk patients （6.5%） and low risk patients had no VTE recurrence. The survival curves showed compared with the other three groups, recurrent VTE in patients at high risk was the highest, and the difference was statistically significant （P=0.021）. Conciusion （1）The risk factors of VTE for inpatients are： BMI〉25 kg/m^2, Protein C or protein S deficiency, hyperhomocysteinemia, long-term bed-ridden, severe lung disease. （2）Caprini model is more effective in evaluate the risk of VTE in surgery patients than medicine patients, and in predicting the risk of VTE recurrence, the Caprini risk assessment model is also be useful.
作者
王春玲
崔釜苹
李俊秋
原向芝
王佳
刘丽云
王明晓
WANG Chun-ling, CUI Fu-ping, LI Jun-qiu, et al.(Department of Geriatric Medicine, Beijing Meitan General Hospital, Beijing 100028, Chin)
出处
《中国心血管病研究》
CAS
2018年第3期231-234,共4页
Chinese Journal of Cardiovascular Research
基金
煤炭总医院128人才项目(项目编号:H-2011-06)
