下肢深静脉血栓后综合征高危因素的logistic回归分析

Logistic regression analysis of high risk factors of post-thrombotic syndrome after lower extremity deep venous thrombosis

目的探讨下肢深静脉血栓后综合征(PTS)发病高危因素。方法回顾分析复旦大学附属中山医院青浦分院血管外科2014年1月至2017年9月收集的159例下肢深静脉血栓形成(DVT)患者临床资料,经纳入和排除标准,筛选出109例DVT患者入组。患者均根据指南经规范抗凝并溶栓治疗,随访1年,根据Villalta评分表,统计PTS发生率。根据有无PTS将患者分成实验组(有PTS,29例)及对照组(无PTS,80例),记录并随访两组患者个人基本信息,现病史、既往史、体重指数、血栓位置等资料,采用logistic回归分析患者下肢PTS高危因素。结果1年PTS发生率为26.6%(29/109),严重PTS发生率为4.6%(5/109)。肥胖(OR=3.71,95%CI 1.24~11.13)、病程≥2周(OR=5.56,95%CI 1.84~16.83)、既往伴有静脉曲张(OR=5.36,95%CI 1.69~17.00)、髂股静脉血栓(OR=3.58,95%CI 1.21~10.58)以及肿瘤(OR=3.53,95%CI 1.04~11.98)是下肢PTS发病的主要危险因素。结论肥胖、病程长、中央型血栓以及伴有静脉曲张和肿瘤是DVT患者发生PTS的高危因素。

Objective To explore the high risk factors of post-thrombotic syndrome(PTS)after lower extremity deep venous thrombosis(DVT).Methods During January 2014 to September 2017,from department of vascular surgery of Qingpu branch of affiliated Zhongshan Hospital of Fudan University,159 patients with lower limb DVT were retrospectively analyzed.Finally,109 patients met inclusion criteria were included.All patients received normative anti-coagulation and thrombolytic therapy according to the guideline.The incidence of PTS was evaluated according to the Villalta scale during the 1-year follow-up.The patients were divided into two groups including experimental group(PTS,29)and control group(No PTS,80)based on whether having PTS.And the patientsdata including personal information,past and present history,body mass index and location of thrombus were recorded.The rate and high risk factors of PTS were evaluated by Logistic regress analysis.Results The incidence rate of PTS was 26.6%(29/109)within a year,4.6%(5/109)was severe PTS.Obesity(OR=3.71,95%CI 1.24~11.13),disease progress longer than 2-weeks(OR=5.56,95%CI 1.84~16.83),varicose vein of lower limb(OR=5.36,95%CI 1.69~17.00),iliofemoral deep venous thrombosis(OR=3.58,95%CI 1.21~10.58)and cancer(OR=3.53,95%CI 1.04~11.98)were the major risk factor of PTS.Conclusions Obesity,longer disease progress,iliofemoral venous thrombosis,varicose vein and cancer were the high risk factors of PTS after DVT.