脊髓损伤患者全身炎症综合指数与深静脉血栓形成相关性研究  

Correlation between aggregate index of systemic inflammation and deep vein thrombosis in patients with spinal cord injury

作　　者：田飞 赵晨光 胡旭 郗宵 陆宇珩 刘新禹 从翔宇 薛艺珂 孙晓龙 袁华 金铭亮 TIAN Fei;ZHAO Chenguang;HU Xu;XI Xiao;LU Yuheng;LIU Xinyu;CONG Xiangyu;XUE Yike;SUN Xiaolong;YUAN Hua;JIN Mingliang(Department of Rehabilitation Medicine,Xijing Hospital,Air Force Military Medical University,Xi’an 710032,China;Department of Diagnostic Radiology,Xijing Hospital,Air Force Military Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学第一附属医院康复医学科,陕西西安710032 [2]空军军医大学第一附属医院放射诊断科,陕西西安710032

出　　处：《陕西医学杂志》2025年第4期475-479,共5页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(82272591);空军军医大学第一附属医院助推项目(XJZT24QN20)。

摘　　要：目的:探究脊髓损伤(SCI)患者全身炎症综合指数(AISI)与深静脉血栓(DVT)之间的关系以及这种关系的意义。方法:回顾性分析407例SCI患者的临床资料,包括入院时的性别、年龄、血型、吸烟史、是否手术、是否骨折、受伤到入院时间、脊髓损伤平面、受伤原因、美国脊髓损伤协会(ASIA)分级、高血压病史、糖尿病史、血小板计数、中性粒细胞计数、单核细胞计数、淋巴细胞计数、DVT等。DVT是指入院时经彩色多普勒超声检查确诊。通过Logistic回归分析和亚组分析研究AISI与DVT的独立相关性。结果:在382例符合条件的受试者中,有88例(23.1%)出现DVT,79.6%为男性,平均年龄(42.6±12.9)岁。经二分类Logistic回归分析,模型1调整了混杂因素年龄、性别,提示AISI与DVT独立相关(OR=1.48,95%CI:1.06~2.07,P=0.02);模型2新增加了混杂因素吸烟、是否手术、是否骨折、脊髓损伤平面、ASIA分级,提示AISI与DVT仍独立相关(OR=1.44,95%CI:1.02~2.03,P=0.04);模型3新增加了混杂因素受伤原因,提示AISI与DVT仍独立相关(OR=1.47,95%CI:1.04~2.09,P=0.03)。对调整的混杂因素进行了亚组分析,发现各亚组之间不存在交互作用(P>0.05)。结论:AISI是SCI后DVT的独立危险因素,AISI与DVT成直线关系,DVT会随着AISI的升高而风险变大;在临床中对于AISI升高的DVT患者,应重点关注并制定个性化的康复治疗策略。Objective:To investigate the relationship between the aggregate index of systemic inflammation(AISI)and deep vein thrombosis(DVT)in patients with spinal cord injury(SCI)and the significance of this relationship.Methods:Clinical data of 407 SCI patients were retrospectively analysis,including gender,age,blood type,smoking history,surgery,fracture,time from injury to admission,plane of spinal cord injury,cause of injury,American Spinal Injury Association(ASIA)classification,history of hypertension,history of diabetes,platelet count,neutrophil count,monocyte count,lymphocyte count,DVT,etc.DVT was defined as diagnosed on admission by color doppler ultrasonography to confirm the diagnosis.The independent correlation between AISI and DVT was investigated by logistic regression analysis and subgroup analysis.Results:Of the 382 eligible subjects,88(23.1%)presented with DVT,79.6%were male,and the mean age was 42.6±12.9 years.After two-category logistic regression analysis,model 1 adjusted for the confounders age and gender,suggesting that AISI was independently associated with DVT(OR=1.48,95%CI:1.06~2.07,P=0.02);model 2 added the confounders of smoking,whether or not surgery was performed,whether or not the fracture was performed,the plane of spinal cord injury,and the ASIA classification,suggesting that AISI was still independently associated with DVT(OR=1.44,95%CI:1.02~2.03,P=0.04);Model 3,with the newly added confounding factor cause of injury,suggested that AISI remained independently associated with DVT(OR=1.47,95%CI:1.04~2.09,P=0.03).Subgroup analyses of adjusted confounders revealed no interaction between subgroups(P>0.05).Conclusion:Our findings suggest that AISI is an independent risk factor for DVT after SCI.AISI is linearly related to DVT,and DVT becomes riskier with elevated AISI.In the clinic,patients with DVT with elevated AISI should be focused and personalized rehabilitation strategies should be developed.

关 键 词：脊髓损伤 全身炎症综合指数 深静脉血栓 相关性研究 危险因素 回归分析 

分 类 号：R681.5[医药卫生—骨科学]