颅内静脉窦血栓形成后血栓复发的相关分析  

Relevant analysis of thrombosis recurrence after cerebral venous sinus thrombosis

作　　者：李鑫[1] 翟少朋 王蕾[1] 张振昶[1] 吕文明[1] 李鸣明[1] 王力群[1] 王皓月[1] 张玉芳[3] 蒋珍秀[4] 陈合成[5] 武国德[1] LI Xin;ZHAI Shao-peng;WANG Lei;ZHANG Zhen-chang;Lü Wen-ming;LI Ming-ming;WANG Li-qun;WANG Hao-yue;ZHANG Yu-fang;JIANG Zhen-xiu;CHEN He-cheng;WU Guo-de(Department of Neurology,Second Hospiual of lanzhouu Unirersiy,lanzhou 730030,China;不详)

机构地区：[1]兰州大学第二医院神经内科,甘肃兰州730030 [2]兰州大学第二临床医学院,甘肃兰州730000 [3]甘肃省妇幼保健院妇产科,甘肃兰州730050 [4]兰州大学第一医院神经内科,甘肃兰州730000 [5]甘肃省人民医院脑血管中心,甘肃兰州730000

出　　处：《中国实用内科杂志》2020年第7期576-579,共4页Chinese Journal of Practical Internal Medicine

摘　　要：目的多中心单区域性长期随访颅内静脉窦血栓形成患者血栓复发情况,研究其复发的相关因素。方法通过分析2006年1月至2016年8月甘肃地区3个综合型医院及1个专科医院确诊颅内静脉窦血栓患者的临床、影像学、实验室的完整资料并对其进行系统随访,记录再次入院影像学确诊的新发静脉血栓事件。结果纳入166例确诊的颅内静脉窦血栓形成的患者,平均年龄(28.30±0.64)岁,92.8%为女性,87.9%的患者发现病因,109例(65.7%)患者为围生期妇女血液高凝状态,33例(19.9%)患者存在获得性或遗传性易栓因素,13例(7.8%)患者为感染因素所致,4例(2.4%)肿瘤患者,2例(1.2%)患者为口服雌激素类药物所致颅内静脉窦血栓。平均和中位随访时间分别为33.81个月(标准差6.55)和36.00个月(范围0.93~36.00个月)。患者平均口服抗凝剂治疗6.01个月。患者总病死率为1.8%。1年时累积静脉血栓复发率为3.01%,2年时为8.43%,3年时为13.25%。年龄(每增加5岁)[危险比(HR),1.065;P=0.001]、静脉血栓病史(HR,4.094;P=0.008)、结缔组织病史(HR,4.901;P=0.024)、肿瘤病史(HR,3.667;P=0.036)与复发独立相关。结论 3年随访过程内随着时间延长,其复发性静脉血栓形成的累积风险会增加,且既往有发病年龄(每增加5岁)、静脉血栓病史、结缔组织病史及恶性肿瘤病史患者存在较高的复发风险。Objective To malce a long-term follow-up study of the recurrence rate of thrombus in patients by multicenter insingle region, and to study the related factors for recurrence. Methods Analyse the clinical,imaging and laboratory data ofpatients with confirmed diagnosis of venous sinus thrombosis, and record the new venous thrombosis events confirmed byreadmission imaging in three general hospitals and one specialized hospital in Gansu from January 2006 to August 2016.Results Totally 166 patients(mean age(28.30±0.64)years,92.8% female)with CVT were included, with a mean age of(28.30 ± 0.64)years, and 92.8% were female. Cause was found in 87.9% of patients. Totally 109 patients(65.7%)wereperinatal women with hypercoagulability,33 patients(9.9%)had acquired or inherited thrombosis-prone factors,and 13 patients(7.8%)were infected. Four patients(2.4%)patients were with tumors and 2 patients(1.2%)were with intracranialvenous sinus thrombosis caused by oral estrogens. The mean and median follow-up time was 33.81 months(standarddeviation 6.55)and 36.00 months(range 0.93-36 months),respectively. The patients were treated with oral anticoagulanttreatment for an average of 6.01 months. The total mortality rate was 1.8%. The cumulative recurrence rate of venousthrombosis was 3.01% at 1 year,8.43% at 2 years and 13.25% at 3 years. Age(increased by 5 years)(HR,1.065;P=0.001)and previous venous thromboembolism(HR,4.094;P=0.008),connective tissue disease(HR,4.901;P=0.024)and tumors(HR,3.667;P=0.036)were independently associated with recurrence. Conclutions During an average 3-year follow-up period,the cumulative risk of recurrent venous thrombosis increases with time,and age(increased by 5 years)and history of PVTE,CTD and malignant tumors are found to be risks of higher recurrence in patients.

关 键 词：颅内静脉窦血栓形成 围产期 静脉血栓 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]