急性下肢深静脉血栓形成患者并发肺栓塞的危险因素研究

Study on risk factors of pulmonary embolism in patients with acute deep vein thrombosis of lower extremities

目的研究急性下肢深静脉血栓形成(deep vein thrombosis,DVT)患者并发肺栓塞(pulmonary embolism,PE)的危险因素。方法回顾性分析新疆医科大学第一附属医院血管甲状腺外科2015年1月至2020年1月的312例急性下肢DVT患者资料,应用Logistic回归分析合并PE的危险因素。结果动脉血氧分压≤80 mmHg(OR=0.223,95%CI=0.093~0.533,P=0.001)、合并慢性心血管疾病(OR=5.845,95%CI=1.979~17.262,P=0.001)、合并慢性肺部疾病(OR=6.286,95%CI=1.326~29.802,P=0.021)、累及股静脉(OR=2.917,95%CI=1.070~7.951,P=0.036)、累及腘静脉(OR=4.788,95%CI=1.803~12.712,P=0.002)和D-二聚体>1000 mg/L(OR=0.121,95%CI=0.020~0.752,P=0.023)是急性下肢DVT患者发生PE的危险因素。结论急性下肢DVT患者合并慢性心血管疾病、慢性肺部疾病、血栓累及股静脉和腘静脉、动脉血氧分压的降低和D-二聚体水平偏高与PE发生密切相关。

Objective To study the risk factors of pulmonary embolism(PE)in patients with acute deep vein thrombosis(DVT)of lower extremities.Methods The clinical data of 312 patients with acute DVT in the Department of Vascular and Thyroid Surgery,the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2020 were analyzed retrospectively,and Logistic regression analysis was used to analyze the risk factors of PE.Results Arterial partial pressure of oxygen≤80 mmHg(OR=0.223,95%CI=0.093~0.533,P=0.001),combined with chronic cardiovascular disease(OR=5.845,95%CI=1.979~17.262,P=0.001),combined with chronic pulmonary disease(OR=6.286,95%CI=1.326~29.802,P=0.021),DVT involved with femoral vein(OR=2.917,95%CI=1.070~7.951,P=0.036),DVT involved with popliteal vein(OR=4.788,95%CI=1.803~12.712,P=0.002),D-dimer>1000 mg/L(OR=0.121,95%CI=0.020~0.752,P=0.023)are risk factors for PE in patients with acute DVT of lower extremities.Conclusion Partial pressure of arterial oxygen,combined with chronic cardiovascular disease and chronic pulmonary disease,DVT involved with femoral vein and popliteal vein,decrease of arterial partial pressure of oxygen and the high level of D-dimer are closely related to the occurrence of PE in patients with acute DVT of lower extremities.