缺血性脑卒中患者静脉血栓形成危险因素分析

Analysis of Risk Factors of Venous Thrombosis in Patients with Ischemic Stroke

摘要: 目的：对住院缺血性脑卒中病例进行回顾性分析，探索深静脉血栓形成的高危因素，为缺血性脑卒中患者深静脉血栓的防治提供依据。方法：采用回顾性分析方法，从南方医科大学深圳医院电子病历系统随机选取2018年1月至2022年3月入住神经内科的缺血性脑卒中病例，共纳入完整样本298例。以发生深静脉血栓为结局指标，采用单因素和多因素二元Logistic回归分析形成深静脉血栓的独立危险因素。结果：298例缺血性脑卒中病人中有36例住院期间确诊为下肢深静脉血栓形成。单因素分析结果显示入院时NIHSS分值、出院时NIHSS分值、入院时ADL评分、出院时ADL评分、入院时吞咽功能评估分值、入院时MRS分值、出院时MRS分值、半胱氨酸、APTT、D二聚体、左上肢肌力、左下肢肌力、右上肢肌力、右下肢肌力共16项是缺血性脑卒中患者深静脉血栓形成的风险因素，差异有统计学意义(P < 0.05)；二元Logistic分析显示出院时NIHSS分值(OR = 1.033, P = 0.000)、入院时吞咽功能评估分值(OR = 3.988, P = 0.000)、入院时MRS分值(OR = 3.988, P = 0.000)、出院时MRS分值(OR = 2.383, P = 0.012)是静脉血栓发生的独立危险因素。结论：出院时NIHISS分值、入院时吞咽功能评估分值、入院时MRS分值、出院时MRS分值是缺血性脑卒中患者发生深静脉血栓的危险因素。

Abstract: Objective: A retrospective study was conducted to investigate the high-risk factors of the formation of deep venous thrombosis in patients with ischemic stroke so as to provide the basis for the prevention and treatment of deep vein thrombosis in patients with ischemic stroke. Methods: A total of 298 cases of ischemic stroke admitted to the Department of Neurology in Shenzhen Hospital of Southern Medical University from January 2018 to March 2022 were randomly selected by retrospective analysis. Patients’ information was collected from the information platform. With the occurrence of DVT as the outcome index, univariate and multivariate Logistic regression were used to analyze independent risk factors of DVT. Results: Among 298 patients with ischemic stroke, 36 were diagnosed with deep vein thrombosis in the lower limbs during their hospital stay. The results of univariate analysis showed NIHSS score at admission, NIHSS score at discharge, ADL score at admission, ADL score at discharge, swallowing function evaluation score at admission, and VTE (Caprini) after admission score, MRS score at admission, MRS score at discharge, cysteine result, left upper limb muscle strength, left lower limb muscle strength, right upper limb muscle strength and right lower limb muscle strength were the risk factors of deep venous thrombosis in patients with ischemic stroke, and the differences were statistically significant (P < 0.05); Multivariate Logistic analysis showed that NIHISS score at admission (OR = 1.033, P = 0.000), swallowing function assessment score at admission (OR = 3.988, P = 0.000), MRS score at admission (OR = 3.988, P = 0.000) and MRS score at discharge (OR = 2.383, P = 0.012) were independent risk factors for venous thrombosis, with statistically significant differences (P < 0.05). Conclusions: NIHISS score at admission, swallowing function score at admission, MRS score at admission, and MRS score at discharge were risk factors for DVT in patients with ischemic stroke.