慢性心衰合并下呼吸道感染患者血栓风险及血栓形成影响因素分析

Analysis of Thrombosis Risk and Factors Influencing Thrombosis in Patients with Chronic Heart Failure Complicated with Lower Respiratory Tract Infection

目的:探讨慢性心衰合并下呼吸道感染患者血管性血友病因子(vWF)、D-二聚体(D-D)、心型脂肪酸结合蛋白(H-FABP)、血栓弹力图参数水平变化及与血栓形成的关系。方法:选择2020-01-2023-01在本院治疗的慢性心衰合并下呼吸道感染患者98例,其中发生血栓32例(血栓组),未发生血栓66例(无血栓组),同时选取慢性心衰患者98例作为对照组,比较各组临床资料、血vWF、D-D、H-FABP以及凝血和血栓弹力图等指标差异。Logistic回归分析慢性心衰合并下呼吸道感染者发生血栓的影响因素。结果:与对照组比较,血栓组和无血栓组D-D、vWF、H-FABP、MA、EPL、LY30和CI均升高,R、K水平降低,且血栓组较无血栓组升高或降低更明显(P<0.01)。Logistic回归分析结果显示,D-D、vWF、R、K、LY30是慢性心衰合并下呼吸道感染患者发生血栓的影响因素(P<0.05)。结论:慢性心衰合并下呼吸道感染患者血栓风险增高,监测其D-D、vWF及血栓弹力参数有助于评估血栓风险。

Objective:To investigate the changes of vascular Haemophilia factor(vWF),D-dimer(D-D),heart type fatty acid binding protein(H-FABP)levels and thromboelastogram parameters in patients with chronic heart failure complicated with lower respiratory tract infection and their correlation with thrombosis.Method:98 patients with chronic heart failure and lower respiratory tract infection from January 2020 to January 2023 were selected,among them,32 cases had thrombosis(thrombosis group)and 66 cases did not(non thrombotic group),and 98 patients with chronic heart failure were selected as the control group.The differences in clinical data,blood vWF,D-D,H-FABP,as well as coagulation and thromboelastography indicators among each group were compared.Logistic regression analysis was used to analyze the influencing factors of thrombosis in chronic heart failure patients with lower respiratory tract infection.Results:Compared with the control group,D-D,vWF,H-FABP,MA,EPL,LY30,and CI in the thrombus group and non thrombus group were all increased,while R and K levels were decreased.The thrombus group also showed a more significant increase or decrease compared to the non thrombus group(P<0.05 or P<0.01).The results of logistic regression analysis showed that D-D,vWF,R,K,and LY30 were the influencing factors for the occurrence of thrombosis in patients(P<0.05).Conclusion:Patients with chronic heart failure complicated by lower respiratory tract infection have an increased risk of thrombosis,monitoring its D-D,vWF and thrombus elasticity parameters can help assess the risk of thrombosis.