42例合并免疫病的深静脉血栓的特点及诊治体会

Features,diagnosis and treatment of deep venous thrombosis with autoimmunity diseases in 42 cases

目的探讨伴有自身免疫性疾病的深静脉血栓形成的特点及诊断与治疗。方法回顾性分析42例合并免疫性疾病的深静脉血栓形成的特点及诊断、治疗方法。结果42例患者中有15例合并肺栓塞,占35.7%,其中抗磷脂抗体阳性者7例。全部病例经溶栓、抗凝等治疗后都康复出院,随访期间血沉及C-反应蛋白仍高于正常者16例,其中,复发下肢静脉血栓2例,动脉血栓1例,肠系膜上静脉血栓形成1例。结论自身免疫性疾病并发深静脉血栓形成起病隐匿,易被忽视,应早期诊断。抗磷脂抗体综合征是肺栓塞的高危因素,故抗凝周期应延长;并重视原发疾病的治疗。

Objective To explore the features, diagnosis and treatment of deep venous thrombosis with autoimmunity diseases. Methods The features, diagnosis, treatment and effects of 42 patients with autoimmunity diseases were analyzed retrospectively. Results There were 15 patients （35.7 % ） with pulmonary embolism, in which 7 patients were antiphospholipid antibodies positive. All patients were cured and left hospital alive after treated with thrombolytic and anticoagulant. Erythrocyte ＂sedimentation rate（ESR） and C-reactive protein（CRP） were higher than normal in 16 patients during follow- up, in these 16 patients, 2 of them recurrented deep venous thrombosis, artery thrombosis octcurred in 1 patient, superior mesenteric venous thrombosis was found in 1 patient during follow - up. Conclusion Patients with autoimmunity diseases and deep venous thrombosis are neglected easily in early period and should be diagnosed earlier, antiphospholipid antibodies positive is a risk factor of pul- monary embolism and extended antithrombotic therapy is needed. The treatment of primary diseases is important.