下肢静脉血栓及炎症因子与高龄新型冠状病毒感染患者预后的关系  

Relationship of lower limb venous thrombosis and inflammatory factors with novel coronavirus infection in elderly patients

作　　者：贺梅婷[1] 程颐[1] 刘凤菊[1] 陈洁[1] 赵青[1] 刘东婷[2] He Meiting;Cheng Yi;Liu Fengju;Chen Jie;Zhao Qing;Liu Dongting(Department of Comprehensive Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Medical Imaging,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院综合超声科,北京100029 [2]首都医科大学附属北京安贞医院医学影像科,北京100029

出　　处：《中国医药》2023年第10期1466-1469,共4页China Medicine

摘　　要：目的探讨高龄新型冠状病毒感染患者下肢静脉血栓和白细胞介素6(IL-6)、降钙素原、D-二聚体、C反应蛋白与预后的关系。方法选取首都医科大学附属北京安贞医院2022年12月1日至2023年1月31日收治的新型冠状病毒感染患者223例,根据患者的预后分为死亡组(80例)和存活组(143例)。比较死亡组与存活组患者静脉血栓情况、白细胞介素6(IL-6)、降钙素原、C反应蛋白水平及肺部炎症情况。并总结新型冠状病毒感染患者CT检查特征。结果死亡组男性比例、IL-6、降钙素原、D-二聚体及重度肺炎比例均高于存活组,差异均有统计学意义(均P<0.001)。下肢静脉血栓患者中,死亡组IL-6、降钙素原、D-二聚体水平高于存活组患者[338(143,901)ng/L比51(20,187)ng/L、0.82(0.23,4.96)μg/L比0.10(0.07,0.70)μg/L、7246(4515,14853)μg/L比2070(1182,4182)μg/L],差异均有统计学意义(均P<0.001)。新型冠状病毒感染患者胸部CT显示病变主要位于两肺的外带区域及胸膜下,可跨越肺段的解剖分布,呈多叶浸润,CT主要表现为斑片状磨玻璃影,部分实变、纤维化。结论高龄男性、存在下肢静脉血栓、伴有IL-6、降钙素原、D-二聚体升高的患者新型冠状病毒感染后有较高的死亡风险。Objective To investigate the relationship of lower limb venous thrombosis,interleukin 6(IL-6),procalcitonin,D-dimer,and C-reactive protein with novel coronavirus infection in elderly patients.Methods A total of 223 patients with novel coronavirus infection admitted to Beijing Anzhen Hospital,Capital Medical University from December 1,2022 to January 31,2023 were selected.They were divided into death group(80 cases)and survival group(143 cases)according to the prognosis.Venous thrombosis,IL-6,procalcitonin,C-reactive protein,and severe pulmonary inflammation were compared between the death group and the survival group.CT characteristics of patients with novel coronavirus infection was summarized.Results The proportion of male,IL-6,procalcitonin,D-dimer and the proportion of severe pneumonia in death group were higher than those in survival group(all P<0.001).In lower limb venous thrombosis patients,levels of IL-6,procalcitonin and D-dimer in death group were higher than those in survival group[338(143,901)ng/L vs 51(20,187)ng/L,0.82(0.23,4.96)μg/L vs 0.10(0.07,0.70)μg/L,7246(4515,14853)μg/L vs 2070(1182,4182)μg/L](all P<0.001).Chest CT lesions of novel coronavirus were mainly located in the peripheral area of both lungs and under the pleura,which can cross the anatomical distribution of lung segments and show multi-lobar infiltration.CT mainly showed patchy ground glass shadows,partial consolidation and fibrosis.Conclusion After novel coronavirus infection,elderly male patients,patients with lower limb venous thrombosis,and patients with elevated IL-6,procalcitonin,and D-dimer have a higher risk of death.

关 键 词：新型冠状病毒感染 下肢静脉血栓 D-二聚体 

分 类 号：R511[医药卫生—内科学]