炎症性肠病合并血栓的回顾性研究  

Inflammatory bowel disease with thrombosis: a single center retrospective study

作　　者：李瑾 魏娟[2] 陈春燕[2] 赵丽[1] 陈志坚 吴琳[2] 吴性江[3] 汪芳裕[2] 刘炯[2] Li Jin;Wei Juan;Chen Chunyan;Zhao Li;Chen Zhijian;Wu Lin;Wu Xingjiang;Wang Fangyu;Liu Jiong(Bengbu Medical College, Anhui Province 233003, China;Department of Gastroenterology, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China;Department of General Surgery, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China)

机构地区：[1]蚌埠医学院,安徽省233003 [2]南京军区南京总医院消化内科,210002 [3]南京军区南京总医院普通外科,210002

出　　处：《中华消化杂志》2019年第1期31-34,共4页Chinese Journal of Digestion

摘　　要：目的分析IBD患者合并血栓的相关临床特征和临床意义。方法纳入南京军区南京总医院2001年3月14日至2017年2月6日经临床症状、内镜、影像学检查和病理确诊合并血栓的27例IBD患者,选取同期住院、性别、年龄相匹配未合并血栓的81例IBD患者为对照组,收集分析患者基本资料、IBD诊治信息和血栓事件。采用t检验和卡方检验进行统计学分析,二元logistic回归分析相关的危险因素。结果合并血栓的IBD患者的确诊年龄为(44.8±15.8)岁,高于对照组IBD患者的(36.0±14.4)岁,差异有统计学意义(t=2.69,P=0.008)。27例合并血栓的IBD患者中,51.9%(14/27)为动脉血栓,29.6%(8/27)为下肢深静脉血栓,11.1%(3/27)累及门静脉系统,3.7%(1/27)为肺栓塞,7.4%(2/27)为弥散性血管内凝血。33.3%(9/27)在血栓诊断前6个月经过手术治疗。二元logistic回归分析显示,确诊年龄与血管置管均为IBD患者发生血栓的独立危险因素(OR=1.04,95%CI 1.01~1.07,P=0.01;OR=5.64,95%CI 1.39~22.96,P=0.02)。经药物或手术治疗后,81.5%(22/27)的患者好转,9.1%(2/22)的患者病情危重,13.6%(3/22)的患者死亡。结论对于有血管置管史、处于疾病活动期、IBD确诊年龄较大的患者应注意血栓的筛查与防治。Objective To analyze the clinical features and clinical significance of patients with inflammatory bowel disease (IBD) complicated by thrombosis. Methods From March 14th, 2001 to February sixth 2017, at Nanjing General Hospital of Nanjing Military Command, 27 IBD patients with thrombosis diagnosed by clinical symptoms, endoscopy, imaging and pathology were enrolled. During the same period, 81 gender and age matched IBD patients without thrombosis were included in the control group. The basic data, information of IBD diagnosis and treatment and thrombotic events of patients were collected and analyzed. T-test and Chi-square test were performed for statistical analysis. Binary logistics regression was used for risk factors analysis. Results The mean age of diagnosis of IBD patients with thrombosis was (44.8±15.8) years, which was higher than that of the IBD patients of control group ((36.0±14.4) years), and the difference was statistically significant (t=2.69, P=0.008). Among 27 IBD patients with thrombosis, arterial thrombosis was 51.9%(14/27), deep venous thrombosis of the lower extremity veins was 29.6%(8/27), portal venous system involved was 11.1%(3/27), pulmonary embolism was 3.7%(1/27) and disseminated intravascular coagulation accounted for 7.4%(2/27). Nine patients (33.3%, 9/27) underwent surgery six months before the diagnosis of thrombosis. The results of binary logistic regression indicated that the age of diagnosis and vascular catheterization were independent risk factors for thrombosis in IBD patients (odds ratio (OR)=1.04, 95%confidence interval (CI)1.01 to 1.07, P=0.01;OR=5.64, 95%CI 1.39 to 22.96, P=0.02). After medicine treatment or surgery, 81.5%(22/27) of the patients improved, 9.1%(2/22) were worse and 13.6%(3/22) died. Conclusion Screening and prevention of thrombosis should be paid attention in IBD patients with a history of vascular catheterization, at active phase and older age when diagnosed.

关 键 词：炎症性肠病 静脉血栓形成 危险因素 

分 类 号：R574[医药卫生—消化系统]