672例静脉血栓栓塞症相关危险因素分析  

Risk factors analysis in 672 hospitalized patients with venous thromboembolism

作　　者：闫振宇[1] 华宝来[1] 马西虎 江嘉义 范连凯[1] 王书杰[1] 朱铁楠[1] 白春梅[1] 潘家绮[1] 赵永强[1] 

机构地区：[1]中国医学科学院,中国协和医科大学北京协和医院血液科,100730 [2]新疆维吾尔自治区中医院血液科 [3]安徽省立友谊医院血液科

出　　处：《中华血液学杂志》2007年第9期579-582,共4页Chinese Journal of Hematology

摘　　要：目的分析静脉血栓栓塞症(VTE)住院患者的患病情况、临床特征和危险因素。方法回顾性分析北京协和医院1994年至2004年住院 VTE 病例的患病趋势、人口学特点、获得性及遗传性危险因素。结果共收集 VTE 患者672例,男:女=1.2:1,中位年龄53(14～92)岁。初发患者580例(86.3%),发病高峰年龄男性患者为40～50岁,女性为50～60岁。主要获得性危险因素有抗磷脂抗体阳性(32.0%)、外伤和(或)手术(31.1%)、肿瘤(17.1%)。其中具有多种获得性危险因素者占35.7%。94例患者在抗凝治疗前取外周血检测了蛋白 C(PC)、蛋白 S(PS)和抗凝血酶(AT)活性。抗凝蛋白总缺陷率为44.7%,以 PC 缺乏以及 PC 与 AT 联合缺乏为主,分别占13.8%和10.6%。同时具有遗传和获得性危险因素者占31.6%。结论研究结果显示综合医院的住院 VTE 病例数呈逐年上升趋势,男性 VTE 患者的初发年龄较女性提早约10年。主要获得性危险因素为抗磷脂抗体阳性、外伤或手术和肿瘤,而遗传性危险因素则以 PC 缺乏和 PC 与 AT 联合缺乏为主。多种危险因素并存是促发 VTE 的重要原因。Objectives To explore the frequency, clinical features and risk factors of venous thromboembolism （VTE） in hospitalized patients. Methods The frequency, demographic features, and acquired and inherited factors of in-patient cases of VTE in Peking union medical college hospital from 1994 to 2004 were analyzed retrospectively. Results Six hundred and seventy-two patients were enrolled. Among them, male to female ratio was 1.2 and the median age was 53 （ 14 - 92 ）. Five hundred and eighty （ 86.3% ） patients were at their first diagnosis with the peak ages between 40 and 50 for men and 50 and 60 for women. More common acquired risk factors were antiphospholipid antibody syndrome （APS） （ 32.0% ）, trauma / surgery （31.1%） and malignancies （ 17.1% ）. 35.7% of the patients had mutiple acquired risk factors. Before the initiation of anticoagulation therapy, the activities of protein C （ PC）, protein S （PS） and antithrombin （AT） were measured in 94 patients. The deficiency of these three natural anticoagulants was 44.7%. Among the anticoagulant deficiencies, PC deficiency was the commonest one （ 13.8% ）. Combined deficiency of PC and AT accounted for 10.6%. 31.6% of the 94 patients had inherited plus acquired risk factors. Conclusions Age for the first event of VTE in the men was about 10 years ahead of that in the women. The major acquired risk factors were APS, trauma/surgery and malignancies, and inherited risk factors were PC deficiency and PC ＋ AT combined deficiencies. It seems that the coexistence of multiple risk factors plays an important role in triggering VTE.

关 键 词：肺血栓栓塞症 深静脉血栓形成 危险因素 易栓症 

分 类 号：R543[医药卫生—心血管疾病]