COVID-19患者深静脉血栓发生的临床特征和危险因素:1771例住院患者回顾性分析  

Clinical features and risk factors of deep vein thrombosis in COVID-19 patients:a retrospective analysis of 1771 hospitalized patients

作　　者：张晓华[1,2] 李传伟 刘雨辉[2,3] 蒋小娟 陈兰 李力[2,4] 曹国强 马翔宇 ZHANG Xiaohua;LI Chuanwei;LIU Yuhui;JIANG Xiaojuan;CHEN Lan;LI Li;CAO Guoqian;MA Xiangyu(Department of General Surgery,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing,400042;Wuhan Huoshenshan Hospital,Wuhan,Hubei Province,430050;Department of Neurology,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing,400042;Department of Respiratory Diseases,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing,400042;Department of Epidemiology,Faculty of Military Preventive Medicine,Army Military University(Third Military Medical University),Chongqing,400038,China)

机构地区：[1]陆军军医大学(第三军医大学)大坪医院普外科,重庆400042 [2]火神山医院,武汉430050 [3]陆军军医大学(第三军医大学)大坪医院神经内科,重庆400042 [4]陆军军医大学(第三军医大学)大坪医院呼吸内科,重庆400042 [5]陆军军医大学(第三军医大学)军事预防医学系军队流行病学教研室,重庆400038

出　　处：《第三军医大学学报》2020年第15期1483-1488,共6页Journal of Third Military Medical University

摘　　要：目的探讨和分析新型冠状病毒病(coronavirus disease 2019,COVID-19)患者深静脉血栓的发生率、临床特征和危险因素。方法回顾性分析2020年2-3月武汉火神山医院收治的1771例确诊COVID-19患者临床资料,对发生深静脉血栓患者的发病情况、疾病严重程度、实验室检查和不同治疗措施进行统计学分析,采用多因素Logistic回归模型对危险因素进行分析。结果1771例COVID-19患者深静脉血栓形成42例,其中重型和危重型患者38例(38/516,7.36%),普通型患者4例(4/1255,0.32%);血栓发生部位:近端3例,远端39例;死亡5例。Logistic回归模型分析显示,年龄、合并肿瘤、D-二聚体水平、INR、机械通气、ICU和激素使用可能为COVID-19患者发生深静脉血栓的高危因素(OR分别为0.929、12.471、0.942、16.698、9.133、9.112、4.423,P<0.05)。结论重型和危重型COVID-19患者深静脉血栓形成风险明显增加,且病死率明显增高;年龄、合并肿瘤、D-二聚体水平、INR、机械通气、ICU和激素使用可能是COVID-19患者血栓形成的独立危险因素。Objective To investigate and analyze the incidence rate,clinical features and risk factors of lower extremity thrombosis in patients with coronavirus disease 2019(COVID-19).Methods In this retrospective analysis,1771 COVID-19 patients admitted in Huoshenshan hospital from February to March 2020 were recruited as the study subjects.Their clinical data were collected.The incidence and severity of deep vein thrombosis,laboratory indicators and treatment measures were analyzed statistically.Multivariate logistic regression analysis was used to analyze the risk factors.Results There were 42 cases of lower limb thrombosis in the 1771 COVID-19 cases,including 38 cases of severe and critical type(38/516,7.36%)and 4 cases of common type(4/1255,0.32%).Among them,3 cases were at proximal end and 39 cases at distal end,and 5 died.Logistic regression analysis showed that age,tumor,D-dimer level,international normalized ratio(INR),mechanical ventilation,ICU and hormone use were high risk factors for deep venous thrombosis in COVID-19 patients(OR=0.929,12.471,0.942,16.698,9.133,9.112,4.423,P<0.05).Conclusion The risk of lower extremity thrombosis is significantly increased in COVID-19 patients,especially in severe and critically ill patients,and the mortality is quite elevated.Age,tumor,D-dimer level,INR,mechanical ventilation,ICU and hormone use are independent risk factors for thrombosis.

关 键 词：新型冠状病毒肺炎 深静脉血栓 发生率 危险因素 

分 类 号：R181.32[医药卫生—流行病学] R543[医药卫生—公共卫生与预防医学]