乳酸脱氢酶与脑卒中后下肢孤立性远端深静脉血栓形成的相关性

Relationship between serum lactate dehydrogenase levels and isolated distal deep vein thrombosis in patients with stroke

目的研究乳酸脱氢酶(LDH)与脑卒中后下肢孤立性远端深静脉血栓形成(IDDVT)的相关性。方法通过一项回顾性病例对照研究,选择脑卒中患者3 002例,分为IDDVT组(1 259例)和非IDDVT组(1 743例)。收集其的人口学及临床资料。采用多因素logistic回归以及限制性立方样条图(RCS)分析LDH和IDDVT的关系。结果两组间人口学及临床资料比较显示,两组间肾病史、房颤史、脑卒中类型和血小板比较,差异均无统计学意义(χ^(2))分别=0、0、0.01,t=1.01,P均>0.05),其他变量差异均存在统计学意义并进一步纳入后续的回归分析中。logistic回归表明,在控制了年龄、性别等混淆因素后,高血清LDH水平者(≥267 U/L)其IDDVT风险仍然更高(OR=1.31,95%CI 1.04~1.66,P<0.05)。RCS模型拟合结果表明,随着LDH水平的升高,IDDVT风险也随之升高,两者间呈线性关系(χ^(2))=0.70,P>0.05)。结论高血清LDH水平是IDDVT的危险因素。临床上对于LDH水平升高的脑卒中患者应警惕其发生下肢深静脉血栓的风险,并尽早行相关检查以期做到早发现、早治疗,改善脑卒中患者的预后。

Objective To study the relationship between serum lactate dehydrogenase(LDH)levels and isolated distal deep vein thrombosis(IDDVT)in patients with stroke.Methods A retrospective case-control study was conducted.Three thousand and two patients with stroke were admitted and divided into IDDVT group(n=1259)and non-IDDVT group(n=1743).Demographic and clinical data were collected.Multivariate regression and restricted cubic spline(RCS)were used to analyze the relationship between LDH and IDDVT.Results Demographic and clinical data between the two groups showed that there were no statistically significant differences in the history of kidney disease,history of atrial fibrillation,type of stroke and platelet between the two groups(χ^(2)=0,0,0.01,t=1.01,P>0.05),while other variables were statistically significant and would be further included in the subsequent regression analysis.After controlling the con-founding factors such as age and gender,patients with high serum LDH level(≥267 U/L)still had a higher risk of ID-DVT(OR=1.31,95%CI 1.04-1.66,P<0.05).The RCS model showed that there was a linear relationship between LDH and risk of IDDVT(χ^(2)=0.70,P>0.05).Conclusion High serum LDH level was a risk factor for IDDVT.More attention should be paid to the patients with elevated LDH levels,which may improve the prognosis of stroke.