血栓闭塞性脉管炎疾病活动度评分系统的建立  

Establishment of scoring system for assessing disease activity of thromboangiitis obliterans

作　　者：程灿[1] 胡何节[1] 王晓天[1] 方征东[1] 

机构地区：[1]安徽医科大学附属安徽省立医院血管外科,安徽合肥230001

出　　处：《中国普通外科杂志》2014年第12期1676-1679,共4页China Journal of General Surgery

摘　　要：目的:建立评估血栓闭塞性脉管炎(TAO)疾病活动度的评分系统。方法:收集2008年—2013收治的88例患者的102份病例资料,将患者的预后归类为保肢和截肢两种,分析每个可能导致截肢的临床特征及实验室检查结果与截肢的相关性。然后,将每个指标与截肢的相关系数乘以100获得该指标的风险评分,从而获得每位患者截肢的风险评分。最后,通过受试者工作特征(ROC)曲线获得截肢风险评分的临界值。结果:经单因素与多因素分析,最终选择多趾溃疡、多趾坏疽、腘动脉受累、中性粒细胞升高、贫血、血小板压积升高及纤维蛋白原升高7个指标作为评估因素。患者最高的可能评分为234分,其中临床评分最高为86分,实验室评分为148分。临床评分、实验室评分及总评分的临界值分别为53.5、38.5、91分。结论:该评分系统在一定程度上可指导TAO患者治疗策略的制定,但其准确性仍需进一步队列研究评估。Objective： To establish a scoring system for assessing the disease activity of thromboangiitis obliterans（TAO）.Methods： One-hundred and four medical records from 88 TAO patients admitted during 2008 to 2013 were collected. The outcomes of the patients were classified as limb salvage and amputation, and the association between amputation and the clinical features and laboratory results that were potentially contributing to amputation were analyzed. The correlation coefficient of each factor with amputation was multiplied by 100 to obtain the risk score, and the cut-off value for amputation was obtained by receiver operating characteristic（ROC） curve analysis.Results： After univariate and multivariate analysis, 7 variables that included multiple digit ulcers, multiple digit gangrene, popliteal artery involvement, neutrophilic leukocytosis, anemia, hyperi brinogenemia and thrombocytosis were finally chosen as assessing variables. The possible maximum score of the patient was 234, in which the clinical score was 86 and laboratory score was 148, respectively. The cut-off value of clinical score,laboratory score and total score was 53.5, 38.5 and 91, respectively.Conclusion： To a certain extent, this scoring system can be used for guiding the selection of effective treatment strategies for TAO patients. However, its accuracy still requires validation by further cohort studies.

关 键 词：血栓性脉管炎 闭塞性 预后 危险性评估 

分 类 号：R654.3[医药卫生—外科学]