原发性高血压患者发生孤立性小腿深静脉血栓的危险因素

Risk factors for isolated calf deep vein thrombosis in patients with primary hypertension

目的探讨原发性高血压患者发生孤立性小腿深静脉血栓(ICDVT)的危险因素。方法回顾性分析60例原发性高血压患者的临床资料,其中经下肢静脉彩超确诊为ICDVT的30例患者纳入血栓组,同期住院治疗的30例非血栓原发性高血压患者纳入对照组。单因素分析2组患者的一般资料及血液学指标,将组间比较有统计学差异的因素进行二元Logistic回归分析独立危险因素。结果2组患者性别、年龄、吸烟史、合并糖尿病、合并冠心病、高血压分级、高血压病程、白细胞计数(WBC)、凝血酶原时间(PT)、活化部分促凝血酶原激酶时间(APTT)、D-二聚体水平、纤维蛋白原(FIB)水平、纤维蛋白原降解产物水平(FDP)比较,差异无统计学意义(P>0.05);而2组腹围、血小板计数、BMI比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,腹围≥90 cm、血小板计数≥400×10^(9)/L是原发性高血压患者ICDVT发生的独立危险因素。结论腹围≥90 cm、血小板计数≥400×10^(9)/L是原发性高血压患者发生ICDVT的独立危险因素,临床应给予重视及监测,及早筛查以预防ICDVT。

Objective To investigate the risk factors for isolated calf deep vein thrombosis(ICDVT)in patients with primary hypertension.Methods The clinical data of 60 patients with primary hypertension were retrospectively analyzed.A total of 30 patients diagnosed with ICDVT by color doppler ultrasound for lower limb were included into the thrombosis group,and 30 patients with non-thrombotic primary hypertension hospitalized during the same period were included into the control group.The univariate analysis was performed for clinical data and hematological indexes between the two groups.All variables with significant differences in the univariate analysis between the two groups were entered into binary Logistic regression to analyze independent risk factors.Results There was no statistically significant difference in gender,age,history of smoking,combined diabetes mellitus,combined coronary heart disease,hypertension grade,hypertension duration,white blood cell count(WBC),prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer level,fibrinogen(FIB)level,fibrinogen degradation product(FDP)level between two groups(P>0.05).There were statistically significant differences in abdominal circumference,platelet count and body mass index(BMI)between the two groups(P<0.05).Logistic regression analysis showed that abdominal circumference≥90 cm and platelet count≥400×10^(9)/L were the independent risk factors for isolated calf deep vein thrombosis in patients with primary hypertension.Conclusion Abdominal circumference≥90 cm and platelet count≥400×10^(9)/L were the independent risk factors for isolated calf deep vein thrombosis in patients with primary hypertension,clinical attention and monitoring should be given to screen and prevent ICDVT as early as possible.