下肢深静脉血栓负荷评分对发生急性肺栓塞的诊断价值  

Diagnostic value of lower extremity venous ultrasound thrombotic load score for acute pulmonary embolism

作　　者：贺梅婷[1] 程颐[1] 刘凤菊[1] 张爽[1] 赵青[1] HE Meiting;CHENG Yi;LIU Fengju;ZHANG Shuang;ZHAO Qing(Department of Comprehensive Ultrasound,Capital Medical University,Beijing Anzhen Hospital,Beijing Institute of Heart,Lung and Blood Vessel Disease,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所综合超声科,100029

出　　处：《心肺血管病杂志》2023年第5期467-471,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨下肢深静脉血栓的相关影响因素以及负荷评分对急性肺栓塞诊断价值。方法:回顾性分析超声确诊的下肢静脉血栓患者116例,根据是否存在急性肺栓塞将患者分为:下肢静脉血栓合并急性肺栓塞(venous thrombosis embolism was associated with acute pulmonary embolism,VT-APE)组和下肢静脉血栓不合并急性肺栓塞(venous thrombosis embolism was not associated with acute pulmonary embolism,VT-N-APE)组。探讨下肢静脉血栓超声声像学特征及血栓的负荷评分对急性肺栓塞的影响。Logistic多因素分析下肢深静脉血栓的患者中形成急性肺栓塞的相关危险因素。结果:VT-APE组61例,男23例,女38例,VT-APE组下肢股腘静脉血栓8例(13.1%),低回声22例(78.6%),下肢肌间静脉血栓占32例(52.5%),低回声55例(90.1%);股腘静脉合并小腿肌间静脉21例(34.4%),低回声42例(68.8%),下肢深静脉血栓超声声像图负荷评分287分。VT-N-APE组55例,男25例,女30例,下肢股腘深静脉血栓7例(12.6%),低回声16例(100%),下肢肌间静脉血栓45例(81.9%),低回声48例(87.2%)。股腘合并小腿肌间静脉3例(5.5%),低回声50例(90%),下肢深静脉血栓超声声像图负荷评分130分。单因素分析两组在D-Dimer、FDP、下肢深静脉血栓超声声像图负荷评分等差异有统计学意义(P<0.05)。Logistics多因素分析显示高龄、超重肥胖、D-Dimer、FDP、下肢深静脉超声声像图血栓负荷评分(P<0.05)是急性肺栓塞的危险因素。结论:VT-APE组下肢深静脉血栓超声声像图负荷评分高于VT-N-APE组,受累下肢静脉血栓的梗阻长度及静脉受累的数目是急性肺栓塞的危险因素。用下肢深静脉血栓超声声像图负荷评分可以提升急性肺栓塞的诊断价值。Objective:To investigate the related influencing factors of deep vein thrombosis of lower extremity and the diagnostic value of load score in acute pulmonary embolism.Methods:Retrospective analysis was performed on 116 patients with lower extremity venous thrombosis diagnosed by ultrasound.According to the presence of pulmonary embolism,patients were divided into:venous thrombosis embolism was associated with acute pulmonary embolism(VT-APE), venous thrombosis embolism was not associated with acute pulmonary embolism(VT-N-APE) Venous thrombosis embolism was not associated with acute pulmonary embolism. Objective to investigate the effects of ultrasonographic characteristics and load score on acute pulmonary embolism of venous thrombosis of lower extremity. Logistic multivariate analysis of independent risk factors associated with acute pulmonary embolism in patients with deep venous thrombosis of lower extremities. Results: In the VT-APE group, 61 cases (23 male cases, 38 female cases), 8 cases (13.1%) of femoral popliteal vein thrombosis of lower extremity, 22 cases (78.6%) of hypoecho, 32 cases (52.5%) of intermuscular vein thrombosis of lower extremity, 55 cases (90.1%) of hypoecho. There were 21 cases (34.4%) of femoral popliteal vein combined with calf intermuscular vein, 42 cases (68.8%) of hypoecho, and 287 points of ultrasonographic load score of deep venous thrombosis of lower extremity. In the VT-N-APE group, there were 55 cases (25 males and 30 females), 7 cases (12.6%) of deep femoritpopliteal vein thrombosis in lower limbs, 16 cases (100.0%) of hypoecho, 45 cases (81.9%) of intermuscular vein thrombosis in lower limbs, and 48 cases (87.2%) of hypoecho. There were 3 cases (5.5%) of femoral popliteal combined with calf intermuscular veins, 50 cases (90%) of hypoecho, and the load score of deep venous thrombosis of lower extremity was 130. Unifactor analysis showed statistically significant differences in D-Dimer, FDP in lower limb femoropoiteal vein thrombosis, femoropoiteal combined with intermuscular

关 键 词：下肢静脉超声 下肢静脉血栓 下肢深静脉血栓负荷评分 急性肺栓塞 

分 类 号：R54[医药卫生—心血管疾病]