卒中患者下肢深静脉血流动力学的影响因素

The influencing factors on deep venous hemodynamics in lower limbs after stroke

目的观察卒中患者下肢深静脉血流动力学变化及其影响因素,为防治下肢深静脉血栓形成提供临床依据。方法将147例卒中患者根据肢体瘫痪程度分为肌力≤Ⅲ级组(53例)和>Ⅲ级组(94例),应用空气容积描记术对各组进行最大静脉流出量(MVO)测定。对年龄、血压、胆固醇、三酰甘油、纤维蛋白原、von W illerbrand因子(vWF)浓度与MVO进行偏相关分析;年龄、高血压、糖尿病、肌力、vWF浓度与MVO进行多元回归分析。结果肌力≤Ⅲ级组患侧MVO为(85±8)%,>Ⅲ级组为(92±7)%,P<0.05。偏相关分析发现vWF浓度与MVO呈负相关,偏相关系数为-0.257 1,P=0.02。MVO与其他变量间无显著相关。结论卒中急性期,肌力和血浆vWF浓度在一定程度上影响下肢深静脉血液回流。

Objective To investigate the influencing factors for hemodynamics in lower limbs and provide information for prevention of deep venous thrombosis （DVT） in lower limbs after stroke. Methods According to the, degree of paralysis in limbs, the stroke patients were divided into muscle strength ≤3 grade group （n =53） and 〉3 grade group （n =94）, and the maximum venous outflow （MVO） in lower limbs was detected by pulse volume recorder. The relationship was analysed between MVO and age, blood pressure, muscle strength, cholesterol, glycerinate, plasma fibrinogen and level of plasma von Willerbrand factor （vWF）. Results The reduction of MVO is correlated with the degree of paralysis of lower limbs. There were negative correlation between MVO and the level of plasma vWF （ r = -0. 2571, P = 0. 02）. Conclusion The level of plasma vWF and muscle strength has some effects on MVO in lower limbs during the acute stage after stroke.