脊髓损伤患者合并下肢深静脉血栓形成的相关因素分析

Analysis of Correlative Factors of Lower Extremity Deep Vein Thrombosis in Patients with Spinal Cord Injury

摘要: 目的：通过横断面研究探讨脊髓损伤患者合并下肢深静脉血栓(DVT)的相关因素。方法：回顾性分析2019年1月至2023年6月于天津医科大学总医院康复医学科住院的脊髓损伤患者共207例，收集临床资料，包括社会学特征(年龄、性别、BMI、吸烟史、饮酒史)、实验室结果(D-二聚体、胆固醇、高密度脂蛋白)、脊髓损伤情况、既往史(高血压、糖尿病、冠心病、肿瘤、贫血、有无激素使用及是否介入早期康复)，根据有无合并下肢深静脉血栓分为DVT组和无DVT组，采用二分类Logistic回归分析筛选脊髓损伤患者合并DVT的相关因素。结果：在本横断面研究中，DVT发病率约为30%，两组患者相比较，其中年龄、D-二聚体、高密度脂蛋白、胆固醇、ASIA分级、合并肿瘤、感染、早期康复介入差异有统计学意义(P < 0.05)，性别、BMI、吸烟史、饮酒史、高血压、糖尿病、冠心病、贫血、激素的使用方面两组差异无统计学意义(P > 0.05)。二分类Logistic回归分析显示，年龄、D-二聚体、高密度脂蛋白、ASIA分级、合并肿瘤、感染、早期康复介入与DVT的发生存在相关性。结论：脊髓损伤患者合并DVT与年龄、D-二聚体、ASIA分级、合并肿瘤、感染呈正相关性，与高密度脂蛋白、早期康复介入呈负相关性，早期应积极控制感染、改善高凝状态、积极进行康复介入以降低DVT发病率。

Abstract: Objective: To investigate the correlative factors of lower extremity deep vein thrombosis (DVT) in patients with spinal cord injury through cross-sectional study. Method: A total of 207 patients with spinal cord injury admitted to the Department of Rehabilitation Medicine, General Hospital of Tian-jin Medical University from January 2019 to June 2023 were retrospectively analyzed, and clinical data were collected, including sociological characteristics (age, sex, BMI, smoking history, smoking and drinking history), laboratory results (D-dimer, cholesterol, high-density lipoprotein), degree of spinal cord injury, previous history (hypertension, diabetes, coronary heart disease, tumors, ane-mia, hormone use, and early rehabilitation intervention). The patients with spinal cord injury were divided into DVT group and without DVT group according to whether they were complicated with DVT. Binary Logistic regression analysis was used to screen the related factors of DVT in patients with spinal cord injury. Result: In this cross-sectional study, the incidence of DVT was about 30%, and the two groups of patients were compared, there were statistically significant differences in age, D-dimer, high-density lipoprotein, cholesterol, ASIA grade, combined tumor, infection, and early rehabilitation intervention (P < 0.05), while there were no statistically significant differences in gender, BMI, smoking history, drinking history, hypertension, diabetes, coronary heart disease, anemia, and hormone use between the two groups (P > 0.05). Binary Logistic regression analysis showed that age, D-dimer, high-density lipoprotein, ASIA grade, combined tumor, infection, and early rehabilitation intervention were correlated with the occurrence of DVT. Conclusion: DVT in patients with spinal cord injury is positively correlated with age, D-dimer, ASIA grade, tumor and infection, and negatively correlated with high-density lipoprotein and early rehabilitation interven-tion. Infection should be actively controlled, hypercoagulability should be improved, and rehabili-tation intervention should be actively carried out to reduce the incidence of DVT.