支气管扩张症术后静脉血栓栓塞症与术前血红蛋白含量的关系分析  

Analysis of the relationship between venous thromboembolism after surgical treatment for bronchiectasis and preoperative hemoglobin amount

作　　者：蔡永圣 陈青山 董红红 陈硕[1] 李欣[1] 叶鑫[1] 傅毅立[1] 陈其瑞[1] 游宾[1] 苗劲柏[1] 李辉[1] 胡滨[1] CAI Yongsheng;CHEN Qingshan;DONG Honghong;CHEN Shuo;LI Xin;YE Xin;FU Yili;CHEN Qirui;YOU Bin;MIAO Jinbai;LI Hui;HU Bin(Department of Thoracic Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing Institute of Respiratory Diseases,Beijing,100020,P.R.China)

机构地区：[1]首都医科大学附属北京朝阳医院、北京呼吸疾病研究所胸外科,北京100020

出　　处：《中国胸心血管外科临床杂志》2023年第11期1561-1566,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.16217)。

摘　　要：目的研究术前血红蛋白含量与支气管扩张症外科治疗术后发生静脉血栓栓塞症(venous thromboembolism,VTE)的相关性及其临床意义。方法回顾性分析2017年6月—2021年11月在首都医科大学附属北京朝阳医院行手术治疗支气管扩张症患者的临床资料。比较VTE患者和非VTE患者血液指标,通过四分位数分组和受试者工作特征(receiver operating characteristic,ROC)曲线分析术前血红蛋白与术后VTE的关系。结果共纳入122例患者,其中男50例、女72例,年龄(52.52±12.29)岁。支气管扩张症术后VTE的总发生率为9.02%(11/122)。术前血红蛋白含量[OR=0.923,95%CI(0.870,0.980),P=0.008]和术后D-二聚体含量[OR=1.734,95%CI(1.087,2.766),P=0.021]是支气管扩张症术后VTE发生的独立影响因素,随着术前血红蛋白含量的升高,支气管扩张症术后VTE的发生率逐渐降低。单独术后D-二聚体预测术后VTE的ROC曲线下面积为0.757,术后D-二聚体联合术前血红蛋白含量的ROC曲线下面积为0.878。结论术前血红蛋白较低是支气管扩张症术后发生VTE事件的独立危险因素;术后D-二聚体联合术前血红蛋白对术后VTE具有更好的预测效能。Objective To study the correlation of preoperative hemoglobin amount with venous thromboembolism(VTE)after surgical treatment of bronchiectasis and the clinical significance.Methods A retrospective study was performed on patients with bronchiectasis who underwent surgical treatment in our center from June 2017 to November 2021.The differences in blood parameters between the VTE patients and non-VTE patients were compared.The relationship between preoperative hemoglobin and VTE was confirmed by quartile grouping and receiver operating characteristic(ROC)curve.Results A total of 122 patients were enrolled,including 50 males and 72 females,with a mean age of 52.52±12.29 years.The overall incidence of VTE after bronchiectasis was 9.02%(11/122).Preoperative hemoglobin amount(OR=0.923,95%CI 0.870-0.980,P=0.008)and D-dimer amount(OR=1.734,95%CI 1.087-2.766,P=0.021)were independent influencing factors for VTE after bronchiectasis.The incidence of VTE after bronchiectasis decreased gradually with the increase of preoperative hemoglobin amount.The area under the ROC curve(AUC)of postoperative D-dimer alone was 0.757,whereas the AUC of postoperative D-dimer combined with preoperative hemoglobin amount was 0.878.Conclusion Low preoperative hemoglobin is an independent risk factor for postoperative VTE.Postoperative D-dimer combined with preoperative hemoglobin amount has a better predictive performance compared with postoperative D-dimer alone for postoperative VTE.

关 键 词：支气管扩张 手术 静脉血栓栓塞症 血红蛋白 D-二聚体 

分 类 号：R562.22[医药卫生—呼吸系统]