首页|神经内科重症监护室中重症急性缺血性脑卒中患者小腿肌间静脉血栓发生率与危险因素

神经内科重症监护室中重症急性缺血性脑卒中患者小腿肌间静脉血栓发生率与危险因素

Incidence and risk factors of calf muscular venous thrombosis in patients with severe acute ischemic stroke in NICU

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目的 探讨神经内科重症监护室中重症急性缺血性脑卒中(AIS)患者小腿肌间静脉血栓(CMVT)发生率并分析其危险因素.方法 回顾性分析2018年4月至2021年12月于南京鼓楼医院神经内科重症监护室治疗的重症AIS患者,发病7 d内行下肢深静脉超声检查,根据是否存在新发CMVT,分为无CMVT组(non-CMVT组,n=144)和CMVT组(n=49).分析重症AIS患者入院后CMVT的发生率及相关危险因素.结果 重症AIS患者 CMVT 发生率为 24.38%(49/201).CMVT 组患者年龄高于 non-CMVT 组[(74.53±9.81)岁 vs(69.19±14.10)岁,t=2.455,P=0.015].CMVT 组心房颤动病史患者的比例更高(44.90%vs29.17%,x2=4.082,P=0.043).CMVT组 D-二聚体水平高于 non-CMVT 组[8.71(1.58,5.67)mg/L vs 3.09(0.89,3.89)mg/L,Z=2.132,P=0.038].单因素 logistic 回归分析示,年龄(OR=0.175,95%CI:0.035~0.309,P=0.015)、心房颤动病史(OR=0.145,95%CI:0.004~0.281,P=0.044)、D-二聚体(OR=0.242,95%CI:0.104~0.370,P<0.01)是 CMVT 发生的影响因素.多因素logistic回归分析显示D-二聚体是重症AIS患者并发CMVT的独立影响因素(OR=1.053,95%CI:1.005-1.104,P=0.030).结论 高龄、心房颤动病史、高D-二聚体促进重症AIS患者并发CMVT,且 D-二聚体水平升高是独立危险因素.
Objective To investigate the incidence of calf muscular venous thrombosis(CMVT)and analyze its risk factors among patients with severe acute ischemic stroke(AIS)in the Neurological Intensive Care Unit(NICU).Methods A retrospective analysis was conducted on patients with severe AIS treated in the NICU of Nanjing Drum Tower Hospital from April 2018 to December 2021.Lower extremity deep vein ultrasound examination was conducted in patients within 7 days of onset.According to the presence or absence of new CMVT,the patients were divided into non-CMVT group(n=144)and CMVT group(n=49).The incidence of CMVT and its related risk factors among patients with severe AIS were analyzed.Results The incidence of CMVT among patients with severe AIS was 24.38%(49/201).The age of patients in the CMVT group were older than that in the non-CMVT group[(74.53±9.81)years vs(69.19±14.10)years,t=2.455,P=0.015].Proportion of patients with atrial fibrillation history was higher in the CMVT group(44.90%vs 29.17%,x2=4.082,P=0.043).D-dimer levels in the CMVT group were significantly higher than that in the non-CMVT group[8.71(1.58,5.67)mg/L vs 3.09(0.89,3.89)mg/L,Z=2.132,P=0.038].Univariate logistic regression analysis showed that age(OR=0.175,95%CI:0.035-0.309,P=0.015),history of atrial fibrillation(OR=0.145,95%CI:0.004-0.281,P=0.044),and D-dimer(OR=0.242,95%CI:0.104-0.370,P<0.01)were correlated with the occurrence of CMVT.Multivariate logistic regression analysis showed that D-dimer was independently associated with CMVT in patients with severe AIS(OR=1.053,95%CI:1.005-1.104,P=0.030).Conclusion Advanced age,history of atrial fibrillation,and high level of D-dimer promote the occurrence of CMVT among patients with severe AIS,and elevated D-dimer is an independent risk factor.

Acute ischemic strokeCalf muscular venous thrombosisIntensive care unitD-dimerAtrial fibrillationDepartment of Neurology

姜婉、张曦、笪红婷、黄嵘、徐运、张馨

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南京大学医学院附属鼓楼医院神经内科,江苏南京 210008

安徽医科大学第一附属医院检验科,安徽合肥 230032

急性缺血性脑卒中 小腿肌间静脉血栓形成 重症监护室 D-二聚体 心房颤动 神经内科

江苏省自然科学基金青年基金

BK20210019

2024

中国临床研究
中华预防医学会

中国临床研究

CSTPCD
影响因子:0.943
ISSN:1674-8182
年,卷(期):2024.37(4)
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