产褥期颅内静脉窦血栓形成的危险因素分析  

Analysis of clinical characteristics and risk factors of patients with cerebral venous sinus thrombosis in the puerperium

作　　者：黎浩然 张晨曦 韩平 姜华[1] 王丹[1] 孙越红[1] 李虓[1] 张丽敏[1] Li Haoran;Zhang Chenxi;Han Ping;Jiang Hua;Wang Dan;Sun Yuehong;Li Xiao;Zhang Limin(Laboratory Diagnosis Center,Beijing Tiantan Hospital,Capital Medical University,Beijing Engineering Research Center of Immunological Reagents Clinical Research,NMPA Key Laboratory for Quality Control of In Vitro Diagnostics,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院实验诊断中心、北京市免疫试剂临床工程技术研究中心、国家药监局体外诊断试剂质量控制重点实验室,北京100070

出　　处：《中国综合临床》2023年第6期447-452,共6页Clinical Medicine of China

基　　金：首都医科大学“本科生科研创新”项目 (XSKY2022288)。

摘　　要：目的探讨产褥期颅内静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的危险因素。方法本研究为回顾性分析。选取首都医科大学附属北京天坛医院2016年1月至2022年11月收治的33例产褥期CVST患者为观察组,另选取本院同时期进行产后随诊的产褥期健康女性61名为对照组。比较两组产褥期女性的年龄、体质量指数(body mass index,BMI)、吸烟史、高血压史、糖尿病史、用药史、生产或流产方式以及各实验室指标水平。分析产褥期CVST的危险因素。呈正态分布的计量资料以x±s表示,组间比较采用两独立样本t检验;非正态分布的计量资料以M(Q_(1),Q_(3))表示,组间比较采用Wilcoxon秩和检验。计数资料以例(%)表示,组间比较采用χ2检验或Fisher确切概率法。建立Logistic回归模型,分析产褥期CVST发生的危险因素。结果观察组BMI和血清乳酸脱氢酶(lactate dehydrogenase,LDH)、α-羟丁酸脱氢酶(alpha-hydroxybutyric dehydrogenase,α-HBDH)、空腹血糖、同型半胱氨酸(homocysteine,HCY)水平和白细胞计数(white blood cells count,WBC)、中性粒细胞计数(neutrophil count,NEU)、中性粒细胞和淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、红细胞分布宽度(red blood cell distribution width,RDW)、平均血小板体积(mean platelet volume,MPV)均高于对照组[(25.51±4.39)kg/m^(2)比(21.94±3.02)kg/m^(2),195.15(183.10,240.98)U/L比165.75(154.55,184.62)U/L,166.60(143.10,188.60)U/L比124.10(116.30,137.90)U/L,(4.88±0.98)mmol/L比(4.25±0.41)mmol/L,8.35(7.10,12.16)μmol/L比6.60(5.30,7.58)μmol/L,9.26(6.56,11.76)×10^(9)/L比7.25(6.23,8.00)×10^(9)/L,7.18(4.66,8.79)×10^(9)/L比3.93(3.25,4.52)×10^(9)/L,4.13(2.27,6.55)比1.63(1.16,1.97),42.80(38.95,47.45)fL比40.70(38.95,42.60)fL,(9.52±0.99)fL比(8.96±0.88)fL],而淋巴细胞计数(lymphocyte count,LY)、血小板分布宽度(platelet distribution width,PDW)均低于对照组[1.58(1.11,1,96)×10^(9)/L比2.50(2.04,2.91)×10^(9)/L,15.60(11.65,16.20)Objective To investigate the risk factors of cerebral venous sinus thrombosis(CVST)during puerperal period.Methods This study was a restrospective analysis,A total of 33 puerperal CVST patients admitted to Beijing Tiantan Hospital,Capital Medical University from January 2016 to November 2022 were selected as the observation group,and 61 puerperal healthy women who underwent postpartum follow-up at the same period in the hospital were selected as the control group.The age,body mass index(BMI),smoking history,hypertension history,diabetes history,drug use history and mode of delivery or abortion of the two groups of women were compared and collected,as well as the level of laboratory indicators.The risk factors of CVST in puerperal period were analyzed.The measurement data of normal distribution were represented by two independent samples t test for comparison between groups.The measurement data of non-normal distribution were expressed as M(Q_(1),Q_(3)),and the Wilcoxon rank sum test was used for comparison between groups.The count data is expressed as number(%),and the comparison between groups is performed usingχ2 test or Fisher exact probability method.Logistic regression model was established to analyze the risk factors of CVST in puerperal period.Results BMI,serum LDH,α-HBDH,fasting blood glucose,HCY levels,WBC,NEU,NLR,RDW and MPV in observation group were higher than those in control group[(30.21±4.25)kg/m^(2) vs(21.94±3.02)kg/m^(2)].195.15(183.10,240.98)U/L vs 165.75(154.55,184.62)U/L,166.60(143.10,188.60)U/L vs 124.10(116.30,137.90)U/L,(4.88±0.98)vs(4.25±0.41),8.35(7.10,12.16)μmol/L vs 6.60(5.30,7.58)μmol/L,9.26(6.56,11.76)×10^(9)/L vs 7.25(6.23,8.00)×10^(9)/L,and 7.18(4.66,8.79)×10^(9)/L vs 3.93(3.25,4.52)×10^(9)/L,4.13(2.27,6.55)vs 1.63(1.16,1.97),42.80(38.95,47.45)fL vs 40.70(38.95,42.60)fL,(9.52±0.99)fL vs 8.96±0.88 fL],LY and PDW were lower than control group[1.58(1.11,1,96)×10^(9)/L vs 2.50(2.04,2.91)×10^(9)/L,15.60(11.65,16.20)fL vs 16.00(15.80,16.30)fL].The differences were statisti

关 键 词：颅内静脉窦血栓形成 产褥期 凝血 

分 类 号：R714.6[医药卫生—妇产科学]