探讨脑梗死患者下肢深静脉血栓形成(LDVT)的血液学指标特点及相关危险因素。
方法:本研究对上海市第五康复医院康复科和上海市第一人民医院2022年6月至2023年6月收治的174例脑梗死患者资料进行回顾性分析。根据下肢静脉彩超检查结果,患者分为LDVT组(35例)和非LDVT组(139例)。我们比较了临床数据和血液学指标(D-二聚体值,纤维蛋白原,白细胞,血小板,尿酸,肌酐,等。)对两组患者进行分析,明确脑梗死并发LDVT的危险因素。
结果:统计学分析显示,LDVT组的D-二聚体值明显高于非LDVT组(P<0.05)。LDVT组的尿酸值显著低于非LDVT组,具有统计学意义(P<0.05)。LDVT组的Brunnstrom分期与非LDVT组差异有统计学意义(P<0.05)。同时,二分类logistic回归分析显示LDVT合并脑梗死与D-二聚体水平相关[OR=1.302,95%CI(1.077,1.575)],尿酸水平[OR=0.995,95%CI(0.990,1.000)],和Brunnstrom分期[OR=3.005,95%CI(1.312,6.880)]。
结论:D-二聚体值,尿酸值,BrunnstromⅠ~Ⅱ期与脑梗死患者LDVT的发生密切相关。D-二聚体值高,低尿酸值,BrunnstromⅠ~Ⅱ期是脑梗死LDVT的独立危险因素。D-二聚体值的早期评估,尿酸值,临床上应考虑Brunnstrom分期的脑梗死。
To explore the characteristics of hematologic indicators and related risk factors of lower extremity deep vein thrombosis (LDVT) in patients with cerebral infarction.
METHODS: This study retrospectively analyzed data from 174 patients with cerebral infarction admitted to The Rehabilitation Department of Shanghai Fifth Rehabilitation Hospital and Shanghai First People\'s Hospital from June 2022 to June 2023. Based on the results of lower limb venous color Doppler ultrasound examinations, patients were divided into two groups: the LDVT group (35 cases) and the non-LDVT group (139 cases). We compared the clinical data and hematologic indicators (D-dimer value, fibrinogen, white blood cells, platelets, uric acid, creatinine, etc.) of the two groups to identify the risk factors of cerebral infarction complicated with LDVT.
RESULTS: Statistical analysis revealed that the D-dimer values of the LDVT group were significantly (P<0.05) higher than those of the non-LDVT group. The uric acid value of the LDVT group was significantly lower than that of the non-LDVT group, with statistical significance (P<0.05). The Brunnstrom staging in the LDVT group was significantly different from that in the non-LDVT group (P<0.05). Meanwhile, binary logistic regression analysis showed that LDVT complicated with cerebral infarction was associated with D-dimer level [OR=1.302, 95% CI (1.077, 1.575)], uric acid level [OR=0.995, 95% CI (0.990, 1.000)], and Brunnstrom staging [OR=3.005, 95% CI (1.312, 6.880)].
CONCLUSIONS: D-dimer value, uric acid value, and Brunnstrom stage I to II are closely related to the occurrence of LDVT in patients with cerebral infarction. High D-dimer value, low uric acid value, and Brunnstrom stage I to II are independent risk factors for LDVT in cerebral infarction. Early assessment of D-dimer value, uric acid value, and Brunnstrom stage of cerebral infarction should be considered in clinical practice.