高原地区原发性急性肠系膜静脉血栓形成的危险因素分析

Risk factors of primary acute mesenteric venous thrombosis in plateau area

目的探讨高原地区原发性急性肠系膜静脉血栓形成(AMVT)的危险因素。方法回顾性分析西藏自治区人民医院2015年1月至2021年7月之间收治的54例原发性AMVT患者,其中男42例,女12例,年龄29~79岁;以同期在本院体检中心体检的190名健康人做为对照。两组比较差异有统计学意义的指标进入Logistic多因素回归分析。采用受试者工作特征(ROC)曲线和曲线下面积评价各指标及模型预测的价值。结果单因素分析显示两组性别、吸烟史、饮酒史及血红蛋白水平差异均有统计学意义(均P<0.05);年龄、居住地海拔、尿酸及体质量指数(BMI)水平差异均无统计学意义(均P>0.05)。Logistic多因素回归分析显示男性(OR=2.466,95%CI:1.166~5.212,P=0.018)、血红蛋白水平升高(OR=2.761,95%CI:1.411~5.403,P=0.003)是高原地区原发性AMVT发生的独立危险因素;上述两个预测指标及预测模型的ROC曲线下面积分别为0.639(95%CI:0.559~0.719)、0.650(95%CI:0.563~0.737)、0.697(95%CI:0.618~0.776)。结论男性、血红蛋白水平升高是高原地区原发性AMVT的独立危险因素。

Objective To explore the risk factors of primary acute mesenteric venous thrombosis(AMVT)in plateau area.Methods Data of 54 primary AMVT cases admitted to the People's Hospital of Tibet Autonomous Region between Jan 2015 and Jul 2021 were retrospectively analyzed.There were 42 males and 12 females,aged from 29-79 years.One hundred and ninty matched volunteers severed as control.Logistic multivariate regression analysis was used to screen out independent risk factors.The receiver operating characteristic(ROC)curve and the area under the curve are used to evaluate the value of each indicator and model prediction.Results Univariate analysis showed that the two groups were significantly different in gender,smoking history,drinking history,and hemoglobin concentration(P<0.05);there was no significant difference in age,altitude of residence,uric acid and BMI(P>0.05).Logistic multivariate regression analysis showed that male(OR=2.466,95%CI:1.166-5.212,P=0.018),elevated hemoglobin levels(OR=2.761,95%CI:1.411-5.403,P=0.003)were independent risk factors for primary AMVT.The area under the ROC curve of the two predictors and prediction model are 0.639(95%CI:0.559-0.719),0.650(95%CI:0.563-0.737),0.697(95%CI:0.618-0.776).Conclusion Male and elevated hemoglobin levels are independent risk factors for primary AMVT in plateau areas.