脊髓损伤患者发生下肢深静脉血栓的危险因素分析

Risk factor for deep vein thrombosis of lower extremity in patients with spinal cord injury

目的探讨脊髓损伤(SCI)患者发生下肢深静脉血栓(DVT)的危险因素。方法收集2018年2月至2021年12月北京积水潭医院收治的147例SCI患者的临床资料,根据下肢DVT发生情况分为两组,发生下肢DVT为血栓组(n=21),未发生下肢DVT为对照组(n=126)。收集有患者的人口学信息、专科信息、实验室检查结果、辅助检查结果,采用多因素Logistic回归模型分析SCI患者发生DVT的危险因素。结果血栓组患者年龄、合并骨折、超敏C反应蛋白(hs-CRP)水平、手术时间、美国脊髓损伤学会(American Spinal Injury Association,ASIA)分级为A/B级、中性粒细胞/淋巴细胞比值(NLR)、D-二聚体(D-D)水平均高于对照组患者,差异均有统计学意义(P<0.05)。两组患者性别、损伤部位比较,差异均无统计学意义(P>0.05)。多因素分析结果显示,年龄≥65岁、hs-CRP≥5 mg/L、ASIA分级为A/B级、NLR≥2.3以及合并骨折均是SCI患者发生下肢DVT的危险因素。结论年龄≥65岁、hs-CRP≥5 mg/L、ASIA分级为A/B级、NLR≥2.3以及合并骨折均是SCI患者发生下肢DVT的危险因素,因此应重视上述危险因素,从而早期诊断SCI患者发生DVT并积极进行干预。

Objective To explore the risk factors for deep vein thrombosis(DVT)of lower extremity in patients with spinal cord injury(SCI).Method Clinical data of 147 SCI patients in the Beijing Jishuitan Hospital from February 2018 to December 2021 were collected.The patients were divided into two groups according to the occurrence of DVT in the lower extremity.The patients with DVT in the lower extremity were the thrombosis group(n=21)and the patients without DVT in the lower extremity were the control group(n=126).The demographic information,specialty information,laboratory examination results and auxiliary examination results of the patients were collected,and the risk factors of DVT in SCI patients were analyzed by multivariate Logistic regression model.Result Age,concomitant fracture,hyper-sensitive C-reactive protein(hs-CRP),operation time,American Spinal Injury Association(ASIA)grade A/B,neutrophil/lymphocyte ratio(NLR),and D-dimer(D-D)level in DVT group were higher than those in control group,the differences were statistically significant(P<0.05).There were no significant differences for gender and injury location between the two groups(P>0.05).The results of multivariate analysis showed that age≥65,hs-CRP≥5 mg/L,ASIA grade of A/B,NLR≥2.3 and concomitant fracture were risk factors for lower extremity DVT in SCI patients.Conclusion The age≥65,hs-CRP≥5 mg/L,ASIA grade was A/B,NLR≥2.3 and concomitant fracture are risk factors for lower extremity DVT in SCI patients,which should be stressed for early diagnosis and treatment of DVT in patients with spinal cord injury.