D-DI/PLT用于藏族预测呼吸系统疾病患者静脉血栓栓塞发生的临床研究

Clinical Study of D-DI/PLT Used to Predict the Occurrence of Venous Thromboembolism in Tibetan Patients with Respiratory Diseases

摘要: 目的：通过分析拉萨市人民医院呼吸重症与危重症医学科藏族呼吸系统疾病患者相关临床资料，寻找早期判断VTE发生的预警指标。方法：2021年9月至2023年4月在拉萨市人民医院呼吸与危重症医学科救治的藏族呼吸系统疾病患者，根据是否发生静脉血栓栓塞(VTE)分为非VTE组和VTE组，比较两组基线和入院24 h检查资料，将组间差异指标进行logistic回归分析，寻找与VTE发生相关的指标，将相关指标进行COX回归分析，寻找可用于预测VTE的指标并进行指标间相关分析。结果：共纳入439例藏族呼吸系统疾病患者进行研究，非VTE组347例，VTE组92例。组间年龄、脉搏、呼吸、白细胞计数、红细胞压积、血小板计数、凝血酶原时间、D-二聚体、总胆红素、尿素氮、尿酸、Caprini评分、D-二聚体与血小板计数比值(D-DI/PLT)均存在明显差异(p < 0.05)。Logistic回归发现白细胞计算、红细胞压积、凝血酶原时间、Caprini评分、D-DI/PLT这5个指标与VTE的发生明显相关。COX曲线显示Caprini评分、D-DI/PLT可以作为预测VTE的指标，且二者无相关性。结论：Caprini评分、D-DI/PLT可以作为预测VTE的指标。其中D-DI/PLT容易获取，可作为藏族患者在呼吸系统疾病救治过程中预测VTE发生的指标指导临床分层治疗。

Abstract: Objective: To search for early warning indicators of VTE occurrence by analyzing the clinical data of Tibetan patients with respiratory diseases in the Department of Respiratory Intensive Care and Critical Care Medicine of Lhasa People’s Hospital. Methods: Tibetan patients with respiratory dis-eases treated in the Department of Respiratory and Critical Care Medicine of Lhasa People’s Hospital from September 2021 to April 2023 were divided into non-VTE group and VTE group according to whether they had venous thromboembolism (VTE). The baseline and 24 h examination data of the two groups were compared, and the difference indexes between the two groups were analyzed by logistic regression. Indicators related to the occurrence of VTE were found, and COX regression analysis was carried out on the relevant indicators to find indicators that could be used to predict VTE and correlation analysis among indicators was carried out. Results: A total of 439 Tibetan pa-tients with respiratory diseases were included in the study, including 347 in the non-VTE group and 92 in the VTE group. There were significant differences in age, pulse, respiration, WBC, HTC, PLT, PT, D-dimer, TBIL, BUN, UA, Caprini score, and D-DI/PLT among groups (p < 0.05). Logistic regression found that five indexes, including leukocyte count, WBC, HTC, PT, Caprini score and D-DI/PLT, were significantly correlated with the occurrence of VTE. COX curve shows that Caprini score and D-DI/PLT can be used as indicators to predict VTE, and there is no correlation between them. Con-clusion: Caprini score and D-DI/PLT can be used as predictors of VTE. Among them, D-DI/ PLT is easy to obtain and can be used as an indicator to predict the occurrence of VTE in the treatment of respiratory diseases in Tibetan patients to guide clinical stratified treatment.