Wells评分应用于脑卒中并发下肢深静脉血栓研究

Application of Wells score in deep vein thrombosis following stroke

目的:探讨Wells深静脉血栓评分量表在脑卒中并发下肢深静脉血栓的应用价值。方法:采用Wells评分评估我科收治的128例脑卒中患者,以静脉加压超声检查确诊下肢深静脉血栓形成。计算Wells评分应用于脑卒中并发下肢深静脉血栓的阳性预测值、阴性预测值、特异度、灵敏度。结果:根据Wells评分,将128例患者分为低度可能组、中度可能组和高度可能组,低度可能组发生静脉血栓症2例(10.52%),中度可能组发生静脉血栓症24例(27.27%),高度可能组发生静脉血栓症18例(85.71%),阴性预测值为89.48%,阳性预测值为85.71%。Wells评分在预测脑卒中并发下肢深静脉血栓形成ROC曲线下面积(AUC)为0.812,最佳分界值为1.5分,敏感度为81.8%,特异度为68.2%。结论:Wells评分可有效预测下肢深静脉血栓形成,值得临床推广应用。

Objective： To investigate the value of Wells deep venous thrombosis scale in the prediction of deep vein thrombosis following cerebral infarction. Methods： 128 stroke patients in our department were evaluated by Wells score,and the deep venous thrombosis of lower extremity was diagnosed by intravenous compression ultrasound. The positive predictive value,negative predictive value,specificity,and sensitivity of Wells score was calculated in the prediction of deep vein thrombosis following stroke. Results： According to Wells score,128 patients were divided into low possibility group,moderate possibility group and high possibility group; the low possibility group had 2 cases of venous thrombosis（ 10. 52%）,the moderate possibility group had 24 cases of venous thrombosis（ 27. 27%）,and the high possibility group had 18 cases of venous thrombosis（ 85. 71%）. The negative predictive value was 89. 48%,and the positive predictive value was 85. 71%. The area under the ROC curve（ AUC） of Wells score in the prediction of deep vein thrombosis following stroke was 0. 812,the best cutoff value was 1. 5,the sensitivity was 81. 8%,and the specificity was 68. 2%. Conclusion： Wells score can predict the deep vein thrombosis of lower extremity effectively,and it is worthy of clinical application.