脑梗死后发生下肢深静脉血栓的相关因素分析  

Analysis of related factors of lower extremity deep vein thrombosis after cerebral infarction

作　　者：马静 马中超 李莹 李宝栋[1] Ma Jing;Ma Zhongchao;Li Ying;Li Baodong(Department 4 of Encephalopathy,Cangzhou Hospital of Integrated Traditional and Western Medicine of Hebei,Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation,Cangzhou 061001,Hebei,China;Hall of Bone Injury Rehabilitation,Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei,Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation,Cangzhou 061001,Hebei,China;Department of Pediatric Orthopedics,Cangzhou Hospital of Integrated Traditional and Western Medicine of Hebei,Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation,Cangzhou 061001,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院脑病四科,河北省中西医结合神经康复重点实验室,河北沧州061001 [2]河北省沧州中西医结合医院(骨科院区)骨伤康复大厅,河北省中西医结合神经康复重点实验室,河北沧州061001 [3]河北省沧州中西医结合医院(骨科院区)小儿骨科,河北省中西医结合神经康复重点实验室,河北沧州061001

出　　处：《血管与腔内血管外科杂志》2025年第1期89-93,共5页Journal of Vascular and Endovascular Surgery

基　　金：河北省中医药管理局中医药类科研计划项目(2021314)。

摘　　要：目的 探讨脑梗死(ACI)后发生下肢深静脉血栓(LEDVT)的相关因素。方法 收集2018年10月至2023年10月河北省沧州中西医结合医院收治的39例ACI并发LEDVT患者的临床资料纳入LEDVT组,依据LEDVT组患者的年龄、性别采用倾向匹配法按1:2比例同期从本院收治的ACI患者中选取78例未发生LEDVT患者纳入NLEDVT组。比较两组患者的临床相关指标,采用Logistic回归模型分析ACI并发LEDVT的危险因素,据此构建Nomogram风险模型并绘制列线图,采用受试者工作特征(ROC)曲线分析Nomogram风险模型对于ACI并发LEDVT患者的预测价值。结果 两组患者合并心房颤动、入院NIHSS评分、肌力≤2级、D-二聚体(D-D)、C反应蛋白(CRP)水平比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,合并心房颤动、入院美国国立卫生研究院卒中量表(NIHSS)评分较高、肌力≤2级、D-D水平升高、CRP水平升高均为ACI后发生LEDVT的危险因素(OR≥1,P<0.05)。Nomogram风险模型经校准曲线分析与实际曲线贴合度良好,校正C指数为0.992。ROC曲线分析结果显示,Nomogram风险模型对于ACI并发LEDVT具有较高的预测价值,曲线下面积(AUC)为0.992。结论 合并心房颤动、肌力≤2级、入院NIHSS评分较高、D-D水平较高、CRP水平较高均为ACI后发生LEDVT的危险因素,据此构建的Nomogram风险模型对于ACI并发LEDVT具有较高的预测价值,临床上应据此完善相关检查与评估,提高防治水平,促进ACI患者的临床恢复。Objective To investigate the related factors of lower extremity deep vein thrombosis(LEDVT)after cerebral infarction(ACI).Method Clinical data of 39 patients with ACI complicated with LEDVT treated in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei from October 2018 to October 2023 were collected and included into the LEDVT group.According to the age and gender of patients in the LEDVT group,propensity matching method was used as 1:2 proportion of 78 ACI patients admitted to our hospital during the same period without LEDVT were selected into the NLEDVT group.The clinical indicators of the two groups were compared,and the risk factors of ACI complicated with LEDVT were analyzed by Logistic regression model.Then,the Nomogram risk model was constructed and the column diagram was drawn.The predictive value of this Nomogram risk model for ACI complicated with LEDVT was analyzed by receiver operator characteristic(ROC)curve.Result There were significant differences in atrial fibrillation,National Institute of Health stroke scale(NIHSS)score on admission,muscle strength≤grade 2,D-dimer(D-D),C-reactive protein(CRP)levels between two groups(P<0.05).Multivariate analysis showed that the risk factors for LEDVT after ACI were atrial fibrillation,higher NIHSS score at admission,muscle strength≤grade 2,increased D-D level,and increased CRP level(OR≥1,P<0.05).The calibration curve analysis of the Nomogram risk model fits the actual curve well,and the calibration C-index was 0.992.ROC curve analysis showed that the Nomogram risk model had high predictive value for ACI concurrent LEDVT,and the area under the curve(AUC)was 0.992.Conclusion Combined with atrial fibrillation,muscle strength≤grade 2,high NIHSS score on admission,high D-D level,and high CRP level are all risk factors for the development of LEDVT after ACI.This Nomogram risk model established by this method has high predictive value for the development of LEDVT after ACI.Therefore,relevant examination and evaluation should be

关 键 词：急性脑梗死 下肢深静脉血栓 相关因素 风险模型 

分 类 号：R543[医药卫生—心血管疾病]