| 孙葵葵,王辰,庞宝森,杨媛华,何文,陈天风,赵奇煌,张健.急性脑卒中住院患者深静脉血栓形成危险因素分析[J].Chinese journal of Epidemiology,2004,25(12):1019-1023 |
| 急性脑卒中住院患者深静脉血栓形成危险因素分析 |
| Study on the risk factors of deep venous thrombosis in acute hospitalized stroke patients |
| Received:February 01, 2004 Revised:February 01, 2004 |
| DOI： |
| KeyWord: 脑卒中 深静脉血栓形成 危险因素 |
| English Key Word: Stroke Deep venous thrombosis Risk factor |
| FundProject:国家"十五"科技攻关课题基金资助项目(2001BA703B15) |
| Author Name | Affiliation | | SUV Kui-kui | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | WANG Chen | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | PANG Bao-sen | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | YANG Yuan-hua | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | HE Wen | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | CHEN Ttan-feng | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | ZHAO Qi-huang | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences | | ZHANG Jian | Beijing Institute of Respiratory Medicine, Beijing Chuoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing 100020,China Corresponding author: SUN Kui-kui 100050 Beijing, Tiantan Hospital to Capital University of Medical Sciences |
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| Abstract: |
| 目的 前瞻性病例对照研究分析急性脑卒中住院患者深静脉血栓形成(DVT)的危险因素。方法 连续调查了2001年12月至2002年12月收住北京朝阳医院神经内科及神经外科的脑卒中患者,经CT或MRI检查证实符台脑卒中诊断,共计488例 调查步骤:(1)在入院次日清晨空腹抽每位入选患者血,进行D-二聚体(D-dimer)、血栓调节蛋白(TM)和抗凝血酶-Ⅲ(AT-Ⅲ)检测 (2)于发病7-10天行双下肢血管超声检查,在超声检查当日或次日复查D-dimer和AT-Ⅲ (3)高度可疑DVT的患者一周后重复超声检查 (4)研究结束前记录脑卒中的治疗情况。通过比较脑卒中并发DVT与脑卒中无DVT的患者,筛选脑卒中发生DVT的危险因素。结果 脑卒中患者DVT的发生率为21 7% 多因素logistic分析显示,年龄(≥65岁)(OR=1.655,95%CI:1 005-2 725)、女性(OR=1 993,95%CI:1 221-3.253)、卧床(OR=3 275.95%CI:1 653-6.486)和DVT危险性评分≥2(OR=5.019,95%CI:2.685-9 381)是总体脑卒中患者DVT的独立危险因素 女性(OR=2 828,95%6 CI:1.242-6 438)、白细胞计数> 10 0×109／L(OR=2 032,95%CI:0 897-4 602)和DVT危险性评分≥2(OR=8 809,95%CI:3 081-25 188)是出血性脑卒中患者DVT的独立危险因素 年龄(≥65岁)(OR=2 167,95%CI:1 072-4 381)、卧床(OR=3 008,95%CI:1 43。 |
| English Abstract: |
| Objective To identify the risk factors of deep venous thrombosis(DVT)in hospitalized patients with acute stroke， under a perspective case—control study．I订ethods 488 cases with stroke，identified by CT or MRI and admitted to the department of neur0109y and neurosurgery in Be巧ing Chaoyang HosDital between December 200 l and December 2002 were consecutively studied．There were 328 male and 160 female patients(95．5%Hans)with amean age of 65±11 years，Tanging 22—93 years．The procedure of study would include： (1)General condition，possible risk factorS，symptoms of DVT physical check—up to every eligible patient on first day of admission but the plasma concentrations of D—dimer(ELI≤呈A)，thrombomodulin，antithrombin一Ⅲ and bloOd routine examination were measured on the next morning． (2)The ultrasonography(US)was used for detecting both lower extremities at 7—10 days after the onset of stroke，and D—dimer and AT一Ⅲtests were repeated on the same or next day that the US was taken． (3)The uItrasound examination was repeated after a week in patients with high suspicion of DVT． (4)The therapy of stroke was recorded before the end of the study．Data of stoke patients with DVT was compared with those without DVT to identifv theDVT risk factorS．The effect of each variable on DVT was assessed by logistic regression analysis．Results The prevalence of DVT was 21．7%among the patients．In multivariate analysis，age≥65 years 01d(I：)R=1．655，95%CJ：1．005—2．725)，being male(oR=1．993，95%CJ：1．22l一3．253)，bedridd肌(oR=3．275，95%(x：1．653—6．486)and DVT asseSsment scores≥2(OR=5．019，95%C，：2．685—9．381)were independently assOciated with DVT in all the stroke patients． Being maIe(oR=2．828，95%C工：1．242—6．438)，white b100d celI count>10．0×10'／L(OR=2．032，95%CJ：0．897—4．602)and DVT assessment scores≥2(oR=8．809，95%C，：3．081—25．188)were the independent risk factors of DVT in hemo”hagic stroke group．Age≥65 years 01d(0尺：2．167，95%Cf：1．072—4．381)，bed“dden(oR=3．008，95%CJ：1．435—6．307)and DVT assessment scores≥2(oR=2．600，95%CI：1．077—6．278) were the independeni risk factors of DVT in ischemic stroke group．Conclusions Patients hoS硝talized with acute strOke were under high risk of DVT．Data suggested that 0ld age，female，bedridden and h逸h DVT assessment scores≥2 were independent risk factors for DVT in acutestroke patients that called for supervision and prophylaxis on DVT． |
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