无下肢静脉疾病症状人群及下肢静脉曲张患者髂静脉狭窄及相关因素分析:历史性队列研究

Analysis of iliac vein stenosis and relevant to factors in crowds without lower extremity venous disease and symptoms and patients with lower extremity varicose vein:a historical cohort study

目的了解髂静脉狭窄在无下肢静脉疾病且无下肢静脉曲张、水肿、色素沉着等症状的人群(简称“无症状人群”)及下肢静脉曲张患者中的发生情况,同时分析影响髂静脉狭窄发生的相关因素。方法按照纳入和排除标准回顾性收集2020–2021年期间于重庆医科大学附属第一医院血管外科就诊的下肢静脉曲张患者以及该院体检中心的无症状人群的CT影像学资料及临床信息,比较无症状人群与下肢静脉曲张患者髂静脉狭窄的发生情况以及分析影响髂静脉狭窄发生的相关风险因素。结果本研究共纳入符合标准的对象268例(无症状人群162例、下肢静脉曲张患者106例),共发生髂静脉狭窄63例(23.5%)。髂静脉狭窄发生率在下肢静脉曲张患者中高于无症状人群[36.8%(39/106)比14.8%(24/162),χ2=17.212,P<0.001]。多因素logistic回归分析结果发现,在无症状人群中,相对于男性患者,女性患者发生髂静脉狭窄风险更高[OR=3.131,95%CI(1.188,8.257),P=0.021],体质量指数越大,发生髂静脉狭窄风险越小[OR=0.802,95%CI(0.666,0.966),P=0.020];在下肢静脉曲张患者中,随着年龄增长,发生髂静脉狭窄的风险降低[OR=0.946,95%CI(0.901,0.993),P=0.026]。结论从本研究结果看,髂静脉狭窄发生率不低,且它在下肢静脉曲张患者中的发生率高于无症状人群,而且与性别、年龄或体质量指数可能存在一定的关系。

Objective To understand the prevalence of iliac vein stenosis in crowds without lower extremity venous disease and symptoms(abbreviated as asymptomatic crowd)and patients with lower extremity varicose vein and analyze relevant to factors of iliac vein stenosis.Methods According to the inclusion and exclusion criteria,the CT imaging data and clinical informations of objects in the department of vascular surgery,the First Affiliated Hospital of Chongqing Medical University from 2020 to 2021 were collected.The objects included the patients with lower extremity varicose vein in the department of vascular surgery of this hospital and asymptomatic crowds in the physical examination center of this hospital.The occurrence of iliac vein stenosis of the objects was compared and the relevant to risk factors affecting the occurrence of iliac vein stenosis were analyzed.Results A total of 268 subjects who met the criteria were included in this study,the iliac vein stenosis was occurred in 63(23.5%)subjects.there were 162 asymptomatic crowds and 106 patients with lower extremity varicose vein.The incidence of iliac vein stenosis was higher in the patients with lower extremity varicose vein than that in the asymptomatic crowds[36.8%(39/106)versus 14.8%(24/162),χ2=17.212,P<0.001].The results of multivariate logistic regression analysis showed that the female crowds had a higher risk of iliac vein stenosis as compared with the male crowds[OR=3.131,95%CI(1.188,8.257),P=0.021]and the crowds with higher body mass index(BMI)had a lower risk of iliac vein stenosis[OR=0.802,95%CI(0.666,0.966),P=0.020]in the asymptomatic crowds,as well as the risk of iliac vein stenosis was decreased in the older patients with lower extremity varicose vein[OR=0.946,95%CI(0.901,0.993),P=0.026].Conclusion From the results of this study,the incidence of iliac vein stenosis is not low,and the incidence rate of patient with lower extremity varicose vein is higher than that of asymptomatic crowd,and there may be associated with gender,age,or BMI.