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Incidence and Risk Factors of Deep Venous Thrombosis in Asymptomatic Iliac Vein Compression: A Prospective Cohort Study 被引量:15
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作者 Min-Kai Wu Xiao-Yun Luo Fu-Xian Zhang 《Chinese Medical Journal》 SCIE CAS CSCD 2016年第18期2149-2152,共4页
Background: Deep vein thrombosis (DVT) may be associated with iliac vein compression. Up to now, the majority of data has come from a retrospective study about the correlation between DVT and iliac vein compression... Background: Deep vein thrombosis (DVT) may be associated with iliac vein compression. Up to now, the majority of data has come from a retrospective study about the correlation between DVT and iliac vein compression. This prospective study was to detemline the incidence of DVT in individuals with iliac vein compression and identify risk factors predictive of DVT. Methods: A total of 500 volunteers without symptoms of venous diseases of lower extremities and overt risk factors of deep venous thrombosis between October 2011 and September 2012 in Shijitan Hospital were enrolled in this cohort study. All the participants underwent contrast-enhanced abdominal computed tomography (CT) to evaluate lilac vein compression. Baseline demographic information and degree of iliac vein compression were collected. They were categorized into ≥50% or 〈50% iliac vein compression group. Ultrasound examination was pertbrmed to screen DVT at the time of CT examination and 3, 6, 9, and 12 months alter the examination. Primary event was DVT of ipsilateral lower extremity. Correlation between DVT and iliac vein compression was estimated by multivariate Logistic regression alter adjusting for age, gender, malignancy, surgery/immobilization, chemotherapy/hormonal therapy, and pregnancy. Results: In 500 volunteers, 8.8% (44) had 〉50% iliac vein compression and 91.2% (456) had 〈50% lilac vein compression, lpsilateral DVT occurred in six volunteers including two in iliofemoral vein, two in popliteal vein, and two in calf vein within 1 year. Univariate analysis showed that the incidence of DVT was 6.8% in 〉_50% compression group, significantly higher than that in 〈50% compression group (0.7%) (Х^2= - 12.84, P 0.01). Patients with malignancy had significantly higher incidence of DVT than those without malignancy (Х^2 = 69.60, P〈 0.01 ). Multivariate Logistic regression indicated that iliac vein compression and malignancy were independent risk factors of DVT. Alter adjustment for malignancy, patients with ≥50% iliac vein compression had 10-fold increased risk of developing DVT (adjusted relative risk [RR] = 10.162, 95% confidence interval [CI]: 1.149-89.865, P = 0.037). In subgroup analysis, patients with malignancy and -〉50% iliac vein compression had 12-fold increased the risk of DVT than those without malignance and ≥50% compression (RR = 12.389, 95% CI: 2.327-65.957, P-0.003). Conclusions: lliac vein compression is common, but the incidence of DVT is low. Only individuals with ≥50% lilac vein compression or compression combined with other risk factors might have significantly increased the risk of DVT. Further study is recommended to improve prevention strategies for DVT in significant iliae vein compression. 展开更多
关键词 Deep Venous Thrombosis iliac vein compression: logistic models
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静脉受压动物模型的建立及意义 被引量:2
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作者 盛华均 孙善全 《中国临床解剖学杂志》 CSCD 北大核心 2007年第6期690-692,共3页
目的:建立稳定、可靠的静脉受压的动物模型,为进一步研究髂静脉压迫综合征及其它原因所致的静脉压迫性损伤的病理机制提供实验基础。方法:SD大鼠48只随机分为4组,用4.5#、5#、6#等型号注射针头放置于左髂总静脉旁,用相同的拉力将左髂总... 目的:建立稳定、可靠的静脉受压的动物模型,为进一步研究髂静脉压迫综合征及其它原因所致的静脉压迫性损伤的病理机制提供实验基础。方法:SD大鼠48只随机分为4组,用4.5#、5#、6#等型号注射针头放置于左髂总静脉旁,用相同的拉力将左髂总静脉和左髂总动脉与针头一同结扎,抽出针头,造成髂静脉不同程度的受压、狭窄。观测左髂总静脉腔内压力的变化和不同时间点的病理学改变(HE/Masson染色)以及左下肢的术后表现。结果:4.5#、5#针头组出现明显的髂静脉压力增高(P<0.05),4.5#针头组左下肢术后出现淤血、涨肿,术后3d逐渐恢复。病理改变随时间推移而愈发明显。假手术组、6#针头髂静脉压力则没有明显的变化。结论:用5#针头辅助作部分髂静脉结扎,是模拟人左髂总静脉受压的最佳选择;静脉受压后血流动力学的改变将导致管壁重塑。 展开更多
关键词 髂静脉受压综合征 动物模型 大鼠 意义
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基线增强CT联合临床资料预测非典型左髂总静脉受压继发下肢深静脉血栓的风险模型构建 被引量:2
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作者 陈德华 刘子蔚 +4 位作者 蔡志平 黄绍怀 徐峰 邓凌达 胡秋根 《分子影像学杂志》 2023年第5期829-835,共7页
目的探讨基于基线增强CT联合临床资料的非典型左髂总静脉(LCIV)受压患者诊治期间下肢深静脉血栓的发生率及风险预测模型构建。方法回顾性分析2017年6月~2022年10月南方医科大学顺德医院首次诊治为非典型LCIV的患者共137例,且诊治期间均... 目的探讨基于基线增强CT联合临床资料的非典型左髂总静脉(LCIV)受压患者诊治期间下肢深静脉血栓的发生率及风险预测模型构建。方法回顾性分析2017年6月~2022年10月南方医科大学顺德医院首次诊治为非典型LCIV的患者共137例,且诊治期间均未接受药物或物理等措施预防下肢深静脉血栓(DVT)形成。通过随访是否发生下肢深静脉血栓分为无DVT组(n=41)和DVT组(n=96),比较两组之间的基线CT征象及临床资料的差异,采用二元Logistic回归单因素及多因素分析筛选出独立危险因素,采用ROC曲线分析各危险因素的预测效能。结果非典型LCIV继发DVT的发生率为70%(96/137)。单因素二元Logistic回归分析显示,LCIV最小短径、右髂总静脉最小短径、LCIV受压比例、下腰椎前曲角、下肢症状、D-二聚体及纤维蛋白降解产物(FDP)为非典型LCIV继发DVT的危险因素(P<0.05)。多因素Logistic回归分析显示,FDP(OR=1.05,95%CI:1.01~1.1,P=0.002)、下肢症状(OR=12.59,95%CI:2.78~57.12,P<0.001)及LCIV受压比例(OR=1.05,95%CI:1.01~1.09,P=0.02)为独立危险因素。ROC曲线分析显示FDP、下肢症状、LCIV受压比例的ROC曲线下面积分别为0.879、0.826及0.827。联合预测模型曲线下面积为0.921,其敏感度和特异性分别为95.79%及78.05%。结论非典型LCIV继发DVT发生率较高,FDP、下肢症状、LCIV受压比例为其发生的独立危险预测因素,联合3个独立危险因素的预测模型具有较高的预测效能,为非典型LCIV继发DVT患者提供个性化风险评估。 展开更多
关键词 非典型左髂总静脉受压 深静脉血栓 增强CT 风险模型
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左髂总静脉受压继发髂股静脉血栓形成风险预测模型构建和评价
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作者 朱桥华 杨轮 +5 位作者 黄江远 刘勇刚 黄维 罗美华 陈德华 余启荣 《介入放射学杂志》 CSCD 北大核心 2023年第4期371-375,共5页
目的 构建并评价左髂总静脉(LCIV)受压继发髂股静脉血栓形成的风险预测模型。方法 回顾性分析2012年11月至2019年12月在南方医科大学顺德医院接受血管内介入治疗的血栓性髂静脉受压综合征患者临床资料。根据纳入和排除标准选取治疗组和... 目的 构建并评价左髂总静脉(LCIV)受压继发髂股静脉血栓形成的风险预测模型。方法 回顾性分析2012年11月至2019年12月在南方医科大学顺德医院接受血管内介入治疗的血栓性髂静脉受压综合征患者临床资料。根据纳入和排除标准选取治疗组和对照组,两组患者按年龄-性别1∶1进行匹配。根据CT横断面上所测LCIV和右髂总静脉最小短径计算LCIV受压比例。采用Padua量表评分评估静脉血栓栓塞症(VTE)危险因素,多因素logistic回归分析构建左髂股静脉血栓形成风险预测模型,受试者工作特征曲线(ROC)、Hosmer-Lemeshow拟合优度检验及k折交叉验证评价模型预测效能。结果 治疗组共纳入93例患者,其中男23例,女70例,年龄(57.1±16.9)岁(22~88岁)。治疗组、对照组LCIV受压比例分别为(77.10±12.88)%、(42.11±21.22)%(P<0.01),LCIV受压与髂股静脉血栓形成呈相关性,并与VTE危险因素间存在协同作用。所构建预测模型:P(髂股静脉血栓形成概率)=exp(logit P)/[1+exp(logit P)],logit P=-9.07+0.61×VTE危险因素评分+0.13×LCIV受压比例。logit P的ROC曲线下面积为0.940(0.908~0.971),Hosmer-Lemeshow拟合优度为P=0.563,k折交叉验证训练准确度为0.871±0.007,预测准确度为0.844±0.048。结论 基于LCIV受压比例和Padua危险因素评分所建左髂股静脉血栓形成风险模型具有良好的预测效能。 展开更多
关键词 髂静脉受压 髂股静脉血栓形成 风险预测模型 预测效能
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