重症肺炎患者凝血功能监测及其与下肢深静脉血栓形成的相关性

Coagulation function monitoring in patients with severe pneumonia and analysis of its correlation with lower extremity deep venous thrombosis

目的 探讨重症肺炎患者凝血功能监测临床价值及与下肢深静脉血栓形成(DVT)的相关性。方法 以本院收治的121例重症肺炎患者作为研究对象,将出现DVT的67例患者纳入A组,将未出现DVT的54例患者纳入B组。比较两组凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、D-二聚体(D-Dimer)]差异;采用logistic回归分析重症肺炎患者出现DVT的危险因素,采用ROC曲线分析相关指标对重症肺炎患者出现DVT的预测效能。结果 两组患者间年龄、合并高血压比例、深静脉置管比例、APTT、TT、Fbg、D-Dimer水平存在明显差异(P<0.05);logistic回归分析显示,Fbg、D-Dimer水平为重症肺炎患者出现DVT独立危险因素,APTT为保护因素(P<0.05);ROC曲线分析显示,APTT、Fbg、D-Dimer预测重症肺炎患者出现DVT的AUC均显著大于参考线(AUC>0.7,P<0.05)。结论 年龄、合并高血压、深静脉置管、APTT、TT、Fbg、D-Dimer水平与重症肺炎患者出现DVT密切相关,重症肺炎患者凝血功能监测临床价值较高。

Objective To analyze the clinical value of coagulation function monitoring in patients with severe pneumonia and its correlation with lower extremity deep venous thrombosis(DVT).Methods 121 patients with severe pneumonia admitted to our hos-pital were enrolled as the research subjects.67 patients with DVT were included in group A and 54 patients without DVT were en-rolled as group B.The differences in general data and coagulation function indicators[activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fbg),D-Dimer]were collected and compared between the two groups.The risk factors of DVT in patients with severe pneumonia were analyzed by logistic regression analysis.ROC curve was used to analyze the predictive efficien-cy of related indicators on the occurrence of DVT in patients with severe pneumonia.Results There were significant differences in age,proportion of patients with hypertension,proportion of deep vein catheterization,APTT,TT,Fbg and D-Dimer between the two groups(P<0.05).Logistic regression analysis showed that Fbg and D-Dimer levels were independent risk factors for DVT in patients with severe pneumonia,and APTT was a protective factor(P<0.05).ROC curve analysis showed that the AUCs of APTT,Fbg and D Dimer in predicting the occurrence of DVT in patients with severe pneumonia were significantly higher than the reference lines(AUC>0.7,P<0.05).Conclusion Age,hypertension,deep vein catheterization,APTT,TT,Fbg and D-Dimer are closely related to the occurrence of DVT in patients with severe pneumonia,and the clinical value of monitoring coagulation function in patients with severe pneumonia is high.