大隐静脉曲张患者静脉形态、血流特征与临床严重程度的相关性研究  

Association Between Vein Diameters, Reflux Characteristics, and Clinical Severity in Patients with Varicose Veins in Lower Extremities

作　　者：杨倩 赵永锋 陈曦 刘丽文 周晓东 Yang Qian;Zhao Yongfeng;Chen Xi;Liu Li wen;Zhou Xiaodong(Department of Ultrasound,Xijing Hospital of the Forth Military Medical Univcrsily,Xi’an,Shanxi 710032,China;Ultrasound Diagnosis and Treatment Center Xi’an International Medical Center Hospital,Xi’an,Shanxi 710100,China)

机构地区：[1]空军军医大学西京医院超声医学科,西安市710032 [2]西安国际医学中心医院超声诊疗中心,西安市710100

出　　处：《中国超声医学杂志》2021年第8期918-921,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81801708)。

摘　　要：目的利用彩色多普勒超声评价下肢静脉曲张患者的静脉内径、反流特征及功能变化,分析其与临床严重程度之间的相关关系。方法选取528例慢性下肢静脉曲张患者。所有患者均进行下肢静脉彩色多普勒超声检查,详细记录有无血栓并测量大隐静脉(GSV)、小隐静脉(SSV)和小腿穿支静脉的内径及瓣膜反流时间,评价受累静脉瓣功能。利用CEAP分级、HASTI评分和静脉临床严重程度评分(VCSS)评估患者症状严重程度。统计学分析临床评分、静脉内径和反流时间的各参数变化及相关关系。结果 528例患者(725条患肢)中,331例(62.7%)患者表现为单侧肢体受累,197例(37.3%)患者表现为双侧肢体受累;平均年龄(54.40±12.79)岁;平均体质量指数(BMI)为(24.60±2.71)kg/m^(2);其中年龄和BMI在CEAP各级中均无显著差异(P>0.05);HASTI评分和VCSS评分均与CEAP各级呈正相关关系(P<0.05);HASTI评分及VCSS评分均与GSV、SSV和小腿穿支静脉的平均内径呈正相关关系(P<0.05);C6组患者的GSV及SSV反流时间均显著大于C1组患者(P<0.05),且HASTI评分及VCSS评分均与GSV及SSV反流时间呈正相关关系(P<0.05)。结论 HASTI评分和VCSS评分可以有效评估下肢静脉曲张患者受累静脉的血流特征。Objective Our goal was to summarize the relationship between vein diameters, reflux characteristics, and clinical severity in consecutive patients with varicose veins in lower Extremities in Northwest China. Methods We evaluated 528 consecutive patients with chronic venous insufficiency who presented to the Department of Ultrasound of Xijing Hospital. Reflux times and the mean diameters of the great saphenous, the small saphenous, and the calf perforator veins based on duplex ultrasound scans obtained in the standing position were recorded. Venous-specific assessment tools heaviness/achiness/swelling/throbbing/itching(HASTI) score, Venous Clinical Severity Score(VCSS), and the clinical/etiological/anatomical/pathophysiological(CEAP) class-were analyzed. Results We analyzed 528 consecutive patients with 725 limbs. The mean age was(54.40±12.79) years;the mean body mass index was(24.60±2.71) kg/m^(2). Three hundred thirty-one(62.7%) patients presented with unilateral limb findings and 197(37.3%), with bilateral limb involvement. No significant changes were noted in age and body mass index across CEAP classes(P>0.05). Both the HASTI score(P<0.05) and the VCSS(P<0.05) correlated with the CEAP class. The HASTI score strongly correlated with the mean diameters of the great saphenous and small saphenous veins(P<0.05) similarly to VCSS(P<0.05 for both). The HASTI score and VCSS correlated equally with the mean diameters of the calf perforator veins(P<0.05). In those with C6, both great saphenous vein(P<0.05) and small saphenous vein reflux times(P<0.05) were significantly higher than those in C1. Both the HASTI score and VCSS strongly associated with the reflux times of the great saphenous(P<0.05) and small saphenous veins(P<0.05). Conclusions Both the HASTI score and VCSS can effectively evaluate the blood flow characteristics in patients with lower limb varicose veins.

关 键 词：下肢静脉曲张 CEAP分级 静脉临床严重程度评分(VCSS) HASTI 彩色多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]