下肢深静脉血栓发病风险的临床等级评估

Clinical grading of risk factors for deep venous thrombosis in lower extremity

目的分析下肢深静脉血栓（lower extremity deep vein thrombosis,LDVT）发病风险因素,尝试建立下肢深静脉血栓发病风险的临床评分分级系统。方法回顾性分析我院2010年10月1日-11月30日疑似下肢深静脉血栓的各科住院患者共677例,对11项风险因素进行等级评估,计算每项风险因素的OR值及赋值,对每位研究对象进行综合评分,建立量化分级系统。结果发病因素评分为2、3、4、5、6、7、8、9、10、11、12分的各组中,血栓发生构成比分别为11.34%、12.63%、18.18%、26.23%、30.65%、36.84%、40.31%、52.08%、57.78%、64.44%、81.58%。通过ROC曲线得出7分为区分血栓和未出现血栓的最佳界点。初步建立分级系统≤3分为低度可疑LDVT,4~6分为中度可疑LDVT,≥7分为高度可疑LDVT。结论本研究建立的LDVT风险评分系统能够为临床评价LDVT发病危险程度提供初步较可靠的依据。

Objective To analyze the risk factors for lower extremity deep venous thrombosis（LDVT） and establish its clinical scoring system.Methods Clinical data about 677 patients with suspected LDVT in lower extremity admitted to our hospital from October 2010 to November 2010 were retrospectively analyzed.Eleven risk factors were assessed according to their grading.OR value of each factor was calculated.A quantitative grading system was established according to the comprehensive score of each patient.Results The incidence of LDVT in lower extremity was 11.34%,12.63%,18.18%,26.23%,30.65%,36.84%,40.31%,52.08%,57.78%,64.44%,and 81.58% respectively in the patients with a risk factor score of 2,3,4,5,6,7,8,9,10,11,and 12.A score of 7 as shown on ROC curve could show the best point in lower extremity with or without LDVT.A grading system with a score ≤ 3,4-6 and ≥ 7 was established for mild,moderate and severe LDVT,respectively.Conclusion The LDVT risk scoring system we established in this study can provide preliminary and reliable evidence for the clinical assessment of risk factors for LDVT in lower extremity.