急性脑梗死并发深静脉血栓的发生时间及危险因素分析

Analysis of occurrence time and risk factors of acute cerebral infarction complicated with deep venous thrombosis

目的探讨急性脑梗死患者并发深静脉血栓(DVT)的发生时间及危险因素,以指导临床防治工作。方法选取北京天坛医院2014年5月至2016年5月收治的1129例急性脑梗死患者作为研究对象,根据是否发生DVT将患者分为有DVT组(n=22)与无DVT组(n=1107),对其信息进行回顾性分析,统计其DVT的发生时间;并通过单因素及多因素logistic回归分析急性脑梗死并发DVT的独立危险因素。结果急性脑梗死患者发生DVT的时间是10.5(4-14)d。单因素分析表明,有DVT组和无DVT组年龄、性别、房颤、吸烟、饮酒、慢性阻塞性肺疾病、周围动脉病、肾衰、抗凝药物、BMI、白细胞、入院血糖值、住院时间比较差异有统计学意义(P<0.05)。多因素进一步证实,肾衰(OR:57.421;95%CI:5.792~569.314)、住院时间(OR:1.148;95%CI:1.071~1.232)是其发生DVT的独立危险因素。结论急性脑梗死患者并发DVT发生的中位时间为10.5 d,肾衰、住院时间是影响急性脑梗死患者发生DVT的独立危险因素。明确这一点有利于确定急性脑梗死患者最佳的预防DVT和治疗持续时间,合理地利用医疗资源及制定个性化的预防治疗策略。

Objective To explore the occurrence time and risk factors of deep vein thrombosis(DVT)in patients with acute cerebral infarction,so as to guide clinical prevention and treatment.Methods 1129 patients with acute cerebral infarction treated in Beijing Tiantan Hospital from May 2014 to May 2016 were selected as the research objects.According to whether DVT occurred,the patients were divided into DVT group(n=22)and non DVT group(n=1107);The information was analyzed retrospectively and the occurrence time of DVT was counted.The independent risk factors of acute cerebral infarction complicated with DVT were analyzed by univariate and multivariate logistic regression.Results The time of DVT in patients with acute cerebral infarction was 10.5(4-14)days.Univariate analysis showed that there were significant differences in age,gender,atrial fibrillation,smoking,drinking,chronic obstructive pulmonary disease,peripheral artery disease,renal failure,anticoagulants,BMI,white blood cell,blood glucose at admission and length of stay between the DVT group and the non DVT group(P<0.05).Multiple factors further confirmed that renal failure[odds ratio(OR)=57.421;95%confidence interval(CI),5.192-569.314)]and length of hospital stay(OR=1.148;95%CI:1.071-1.232)were independent risk factors for DVT.Conclusions The median time of DVT in patients with acute cerebral infarction was 10.5 days.Renal failure and hospital stay were independent influencing factors of DVT in patients with a-cute cerebral infarction.This is helpful to determine the best prevention and treatment duration of DVT in patients with acute cerebral infarction,make rational use of medical resources and formulate personalized prevention and treatment strategies.