摘要
目的探讨下肢深静脉血栓(DVT)患者置管溶栓术(CDT)后发生重度血栓形成后综合征(PTS)的危险因素及其风险预测模型。方法收集2021年1月至2023年6月于山西白求恩医院(山西医学科学院同济山西医院)山西医科大学第三医院行CDT治疗的105例下肢DVT患者的临床资料,根据重度PTS发生情况将其分为发生组(n=25)和未发生组(n=80),分析下肢DVT患者CDT治疗后发生PTS的影响因素,据此构建风险预测模型,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估预测模型的应用价值。结果两组患者年龄、静脉曲张、滤器类别、DVT分型、糖尿病比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,静脉曲张、混合型DVT、年龄﹥60岁、糖尿病、植入永久型滤器均是下肢DVT患者CDT治疗后发生重度PTS的危险因素(P﹤0.05)。根据多因素分析结果构建DVT患者CDT治疗后发生重度PTS的预测模型,其AUC为0.720,95%CI:0.609~0.831,预测价值较高。结论年龄﹥60岁、合并静脉曲张、植入永久型滤器、混合型DVT、合并糖尿病均是下肢DVT患者CDT治疗后发生重度PTS的危险因素,由此构建的风险预测模型具有较高的预测效能,且适用性较好,可为临床治疗提供参考。
Objective To investigate the risk factors and risk prediction model of severe post-thrombotic syndrome(PTS)in patients with deep vein thrombosis(DVT)of lower extremity after catheterization hemolysis(CDT).Method Clinical data of 105 patients with DVT of lower extremity who were treated with CDT in Shanxi Bethune Hospital(Tongji Shanxi Hospital,Shanxi Academy of Medical Sciences),the Third Hospital of Shanxi Medical University from January 2021 to June 2023 were collected.According to the occurrence of severe PTS,they were divided into occurrence group(n=25)and non-occurrence group(n=80).The influencing factors of PTS after CDT treatment in lower extremity DVT patients were analyzed,based on which a risk prediction model was constructed,receiver operating characteristic(ROC)curve was drawn,area under the curve(AUC)was calculated,and the application value of the prediction model was evaluated.Result There were statistically significant differences in age,varicose veins,filter type,DVT type and diabetes between the two groups(P<0.05).The results of multivariate analysis showed that varicose veins,mixed type DVT,age>60 years old,diabetes mellitus and permanent filter implantation were all risk factors for severe PTS after CDT treatment in DVT of lower extremity patients(P<0.05).According to the results of multi-factor analysis,the prediction model for the occurrence of severe PTS after CDT treatment in DVT patients was constructed,the AUC was 0.720 and the 95%CI was 0.609-0.831,indicating high predictive value.Conclusion Age>60 years old,varicose veins,permanent filter implantation,mixed type DVT,and diabetes mellitus are all risk factors for severe PTS after CDT treatment in lower extremity DVT patients.The risk prediction model constructed by this method has high predictive efficacy and good applicability,and can provide reference for clinical treatment.
作者
武鑫
杨涛
田宇
Wu Xin;Yang Tao;Tian Yu(Department of Vascular Surgery,Shanxi Bethune Hospital(Tongji Shanxi Hospital,Shanxi Academy of Medical Sciences),the Third Hospital of Shanxi Medical University,Taiyuan 030032,Shanxi,China)
出处
《血管与腔内血管外科杂志》
2024年第8期901-906,共6页
Journal of Vascular and Endovascular Surgery
基金
山西省卫生健康委科研基金(2020003)。
关键词
深静脉血栓
置管溶栓术
血栓形成后综合征
预测模型
deep vein thrombosis
catheterization hemolysis
severe thrombotic syndrome
prediction model
