青年深静脉血栓伴肺栓塞患者的危险因素分析

doi:10.3969/j.issn.1006-7795.2018.03.005

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (3): 335-340.doi: 10.3969/j.issn.1006-7795.2018.03.005

• 血液病学基础与临床研究 • 上一篇下一篇

青年深静脉血栓伴肺栓塞患者的危险因素分析

冯翠翠, 王芳, 韩雪, 白贝贝, 赵森, 陈烨

首都医科大学附属北京安贞医院血液科, 北京 100029

收稿日期:2018-04-19 出版日期:2018-05-21 发布日期:2018-06-11
通讯作者: 陈烨 E-mail:cycy111@sina.com
基金资助:
首都医科大学附属北京安贞医院院长科技发展基金（2015F01）。

Analysis of risk factors of young patients with deep venous thrombosis with pulmonary embolism

Feng Cuicui, Wang Fang, Han Xue, Bai Beibei, Zhao Sen, Chen Ye

Department of Hematology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China

Received:2018-04-19 Online:2018-05-21 Published:2018-06-11
Supported by:
This study was supported by Dean's Science and Technology Development Fund of Beijing Anzhen Hospital Affiliated to Capital Medical University(2015F01).

摘要/Abstract

摘要： 目的分析青年深静脉血栓（deep venous thrombosis，DVT）伴肺栓塞（pulmonary embolism，PE）患者的危险因素。方法回顾性分析2010年1月至2017年12月首都医科大学附属北京安贞医院收治的经彩色多普勒血管超声或血管造影诊断的45岁以下DVT患者的临床资料，根据是否发生PE分为PE组及非PE组，分别对两组的性别、年龄，血栓部位、血细胞计数、血液生物化学指标，凝血、易栓等指标以及心脏病、吸烟、DVT史、手术、静脉曲张、妊娠/分娩等17种DVT常见危险因素进行统计学分析。结果 262例青年DVT患者中96例伴发PE，发生率为36.6%，病死率为3.1%。患者平均年龄（34.85±7.96）岁，男性多于女性（67.7%vs 32.3%，P=0.004）；PE组C反应蛋白（C reactive protein，CRP）、D二聚体（D-Dimer）、纤维蛋白降解产物（fibrin degradation products，FDP）较非PE组更高（P<0.05），高密度脂蛋白胆固醇（high density lipoprotein-cholesterol，HDL-C）低于非PE组（P<0.05）。PE组DVT史、呼吸道感染、血栓累及多支静脉（≥ 2支）患者明显多于非PE组（P<0.05），多因素分析提示HDL-C降低、CRP升高、既往DVT史、呼吸道感染是青年DVT发生PE的独立危险因素。结论青年DVT患者极易发生PE，重症可导致死亡；其D-Dimer及FDP升高，伴PE者更高，对D-Dimer及FDP极度增高的青年DVT建议行PE筛查。伴呼吸道感染、DVT史、高CRP、低HDL-C患者是DVT发生PE的独立危险因素，青年DVT一旦伴发上述危险诱因，应警惕PE发生。

关键词: 静脉血栓, 青年, 诱因, 肺栓塞

Abstract: Objective To investigate the risk factors of young patients deep vein thrombosis (DVT) patients with pulmonary embolism (PE).Methods The data on clinical manifestations and common 17 risk factors were collected and retrospectively analyzed by statistical methods in 262 patients younger than 45 years old with DVT diagnosed by color flow duplex scan and/or by venography in Beijing Anzhen Hospital from January 2010 to December 2017. These patients were divided into PE group and non-PE group according to whether PE occurred.Results Of 262 patients, 36.6% (96/262) were confirmed to have PE, all of whom were secondary to lower limbs venous thrombosis (40.0%, 96/240). The average age was (34.85±7.96) years. Of PE group, there were higher level of C reactive protein (CRP), D-Dimer, fibrin degradation products (FDP) and lower high density lipoprotein-cholesterol (HDL-C) compared with non-PE group, and significantly more patients with the history of DVT, respiratory infection, multiple veins(≥ 2) involved than non-PE group. HDL-C, CRP the history of DVT and respiratory infection are independent risk factors based on multi-factor analysis.Conclusion Young patients with DVT easily develop into PE,which can lead to death. Screening for PE is essential to patients who have extremely elevated D-Dimer and FDP. We should take active intervention to the young patients with DVT when complicated with respiratory infection, patients who had the history of venous thrombosis, decreased HDL-C or elevated CRP.

Key words: venous thrombosis, youth, risk factors, pulmonary embolism

中图分类号:

R552

冯翠翠, 王芳, 韩雪, 白贝贝, 赵森, 陈烨. 青年深静脉血栓伴肺栓塞患者的危险因素分析[J]. 首都医科大学学报, 2018, 39(3): 335-340.

Feng Cuicui, Wang Fang, Han Xue, Bai Beibei, Zhao Sen, Chen Ye. Analysis of risk factors of young patients with deep venous thrombosis with pulmonary embolism[J]. Journal of Capital Medical University, 2018, 39(3): 335-340.

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青年深静脉血栓伴肺栓塞患者的危险因素分析

Analysis of risk factors of young patients with deep venous thrombosis with pulmonary embolism

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