重症肺炎患者凝血功能与下肢深静脉血栓形成的关联

Correlation between coagulation function and deep venous thrombosis in patients with severe pneumonia

目的 分析重症肺炎患者凝血功能与下肢深静脉血栓(DVT)形成的关联关系。方法 对2019年1月-2021年6月于承德医学院附属医院进行治疗的118例重症肺炎患者进行研究,依据其是否发生DVT将其分为DVT组(n=74)和非DVT组(n=44),对两组患者的各项一般资料和临床资料进行分析,并探讨部分临床指标对重症肺炎患者DVT发生的诊断价值。结果 非DVT组与DVT组患者吸烟、接受抗凝治疗、入院时格拉斯哥昏迷评分(GCS评分)、D-二聚体、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、血小板(PLT)、血小板分布宽度(PDW)、血小板平均体积(MPV)、卧床时间比较,差异有统计学意义(P<0.05)。入院时GCS评分、FIB、APTT、PLT、接受抗凝治疗等5项指标联合应用对重症肺炎患者DVT发生均有较佳的诊断评估价值(P<0.05),受试者工作特征曲线(ROC)曲线下面积(ROC-AUC)(0.95CI)为:0.891(0.800~0.956)。结论入院时GCS评分、FIB、APTT、PLT、接受抗凝治疗与重症肺炎患者DVT发生密切关联,5指标对于患者DVT发生也有较佳的诊断价值,提示凝血功能异常与重症肺炎患者DVT发生存在密切相关性。

OBJECTIVE To analyze the relationship between coagulation function and the formation of lower extremity deep venous thrombosis(DVT) in patients with severe pneumonia. METHODS A total of 118 patients with severe pneumonia admitted in Affiliated Hospital of Chengde Medical College for treatment from Jan 2019 to Jun 2021 were enrolled. They were divided into the DVT group(74 cases) and non-DVT group(44 cases). The general data and clinical data between the two groups of patients were analyzed, and the diagnostic value of some clinical indicators for the occurrence of DVT in patients with severe pulmonary infection was discussed. RESULTS The differences of smoking rate, GCS score, anticoagulation therapy, Glasgow coma scale(GCS score), D-dimer, fibrinogen(FIB), activated partial clotting enzyme live time(APTT), thrombin time(TT), platelet(PLT), platelet distribution width(PDW), average blood platelet volume(MPV) on admission between the non-DVT group and DVT group were significant(P<0.05). The combined application of 5 indicators including GCS score, FIB, APTT, PLT and anticoagulation therapy on admission indicated better diagnostic evaluation value for the occurrence of DVT in patients with severe pulmonary infection(P<0.05), with the area under the ROC curve(ROC-AUC)(0.95CI) of 0.891(0.800-0.956). CONCLUSION GCS score, FIB, APTT, PLT and anticoagulant therapy on admission are closely related to the occurrence of DVT in patients with severe pulmonary infection. The five indicators also have good diagnostic value for the occurrence of DVT in patients, suggesting that abnormal coagulation function is closely related to the occurrence of DVT in patients with severe pulmonary infection.