原发性静脉血栓栓塞症复发的预测因素

The Predictors of Recurrent Unprovoked Venous Thromboembolism

目的分析原发性静脉血栓栓塞症(VTE)复发的预测因素,为临床制定有针对性的预防措施提供参考。方法回顾性收集2017年7月至2020年7月原发性VTE复发患者和未复发患者的一般资料、疾病相关情况及实验室指标,进行单因素分析和多因素分析。结果单因素分析显示,性别、体质量指数(BMI)、吸烟史、首次VTE部位、合并下肢深静脉血栓后遗症(PTS)、D-二聚体、纤维蛋白原降解产物是原发性VTE患者复发的影响因素(P<0.05)。二元logistic回归分析显示,D-二聚体、纤维蛋白原降解产物、PTS、男性、首次栓塞为肺血栓栓塞症(PTE)是原发性VTE患者复发的危险因素(P<0.05)。结论D-二聚体、纤维蛋白原降解产物、PTS、男性、首次栓塞为PTE为原发性VTE复发的独立预测指标,可以根据以上指标调整抗凝方案,同时科学引导患者规律复查。

Objective To investigate the predictors of recurrent unprovoked venous thromboembolism,and to provide reference for targeted intervention.Methods A retrospective analysis was conducted in the recurrent and the non-recurrent patients with unprovoked venous thromboembolism from July of 2017 to July of 2020.The general data of patients,disease-related information and laboratory indicators were collected for univariate analysis and multi-factor analysis.Results Single factor analysis showed that sex,body mass index(BMI),smoking history,VTE site for the first time,post thrombotic syndrome(PTS),D-dimer,fibrinogen degradation products were the influencing factors of recurrence in primary VTE patients(P<0.05).Binary logistic regression analysis showed that D-dimer,fibrinogen degradation product,PTS,male,first embolism as pulmonary thromboembolism(PTE)were risk factors for recurrence in primary VTE patients(P<0.05).Conclusion D-dimer,fibrinogen degradation products,PTS,male and PTE for the first time were independent predictors of recurrence of primary VTE.Anticoagulant regimen can be adjusted according to the above indicators,and patients can be guided to review regularly.