风险列线图模型评估下肢深静脉血栓后综合征患者介入术后支架通畅性的危险因素  

Evaluation of Risk Factors for Stent Patency in Patients with Lower Limb Deep Vein Thrombosis Post Interventional Syndrome Using a Risk Column Chart Model

作　　者：齐永乐 刘娟芳[2] 袁慧峰[2] QI Yongle;LIU Juanfang;YUAN Huifeng(The People's Hospital of Wuyang County,Wuyang Henan 462400)

机构地区：[1]舞阳县人民医院,河南舞阳462400 [2]郑州大学第一附属医院,河南郑州450000

出　　处：《医学临床研究》2024年第8期1141-1143,1147,共4页Journal of Clinical Research

摘　　要：【目的】探讨风险列线图模型评估下肢深静脉血栓后综合征(PTS)患者介入术后支架通畅性的危险因素。【方法】选择2019年10月至2022年6月在两院行髂股静脉球囊扩张联合支架植入术治疗的108例PTS患者,根据术后随访2年的支架通畅情况将其分为通畅组(n=90)和不通畅组(n=18)。采用Logistic回归分析影响术后支架通畅率的因素,根据结果建立列线图预测模型,并采用校准曲线进行验证。【结果】两组体重指数(BMI)、抗血小板治疗、支架数量、血栓堵塞位置、弹力袜支持治疗情况比较,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,高BMI、未进行规范抗血小板治疗、支架数量≥2个、未使用弹力袜是影响PTS患者介入术后支架通畅率的危险因素(P<0.05)。列线图模型结果显示,高BMI、未进行规范抗血小板治疗、支架数量≥2个、未使用弹力袜的PTS患者介入术后支架不通畅风险更高。决策曲线结果显示,当风险阈值为0.2~0.8时,Nomogram曲线高于All和None曲线,提示风险阈值为0.2~0.8时有最大的净效益。【结论】高BMI、未进行规范抗血小板治疗、支架数量≥2个、未使用弹力袜的PTS患者介入术后支架不通畅风险更高。【Objective】To explore the risk factors for assessing stent patency in patients with deep vein thrombosis syndrome(PTS)after interventional procedures using a risk column chart model.【Methods】A total of 108 PTS patients who underwent iliac femoral vein balloon dilation combined with stent implantation in both hospitals from October 2019 to June 2022.Based on the stent patency during a 2-year follow-up,they were divided into a patency group(n=90)and a non patency group(n=18).Using logistic regression analysis to identify factors affecting postoperative stent patency,a column chart prediction model was established based on the results,and validated using calibration curves.【Results】There was a statistically significant difference in BMI(P<0.05),antiplatelet therapy,stent number,thrombus blockage location,and elastic sock support treatment between the two groups(P<0.05).Logistic multiple regression analysis showed that high BMI,lack of standardized antiplatelet therapy,number of stents≥2,and non use of elastic stockings were risk factors affecting stent patency in PTS patients after intervention(P<0.05).The column chart model results showed that PTS patients with high BMI,no standardized antiplatelet therapy,number of stents≥2,and no use of elastic stockings had a higher risk of stent patency after intervention.The decision curve results showed that when the risk threshold was between 0.2 and 0.8,the Nomogram curve was higher than the All and None curves,indicating that there was the maximum net benefit when the risk threshold was between 0.2 and 0.8.【Conclusion】PTS patients with high BMI,lack of standardized antiplatelet therapy,≥2 stents,and no use of elastic stockings have a higher risk of stent patency after intervention.

关 键 词：静脉血栓形成/治疗 血管内操作 危险因素 

分 类 号：R543.6[医药卫生—心血管疾病]