Circulation:新冠肺炎患者的深静脉血栓发生情况

2020-07-17 MedSci原创 MedSci原创

新冠肺炎持续全球肆虐,其极强的传染性提高了对隔离治疗的要求。新冠肺炎患者一旦确诊,活动受限,长时间卧床不活动,会大大增加静脉血栓形成风险。让我们来看看武汉住院的新冠肺炎患者的深静脉血栓形成的发生情况。

本研究旨在调查住院的新冠肺炎患者深静脉血栓(DVT)的发生情况,包括其发生率、风险因素、预后和潜在的血栓预防策略。

纳入了2020年1月29日-2月29日于武汉医院住院治疗的143位新冠肺炎患者。

在这143位新冠肺炎患者(平均63岁,51.7%的为男性)中,66位出现下肢DVT(46.1%:23例近端DVT,43例远端DVT)。与未发生DVT的患者相比,发生DVT的患者的年龄更大、氧合指数更低、心肌损伤率更高、预后更差,包括死亡率更高(34.8% vs 11.7%)和出院率低(48.5% vs 77.9%)。多变量分析显示,在该队列中,仅CURB-65(意识状态、尿素、呼吸频率和血压)评分为3-5分(优势必[OR] 6.122; P=0.031)、 Padua预测得分≥4分(4.016; P=0.04)、D-二聚体>1.0 μg/mL (5.818; P<0.014)和DVT存在关联。联合CURB-65 3-5分、Padua预测得分≥4分和D-二聚体>1.0 μg/mL筛查DVT的灵敏度为88.52%,特异性为61.43%。在Padua预测得分≥4分和入院72小时后进行超声检查的亚组患者中,接受静脉血栓预防的患者的DVT发生率为34.0%(18例),未接受预防治疗的患者的DVT发生率高达66.0%(35例)。

对于住院治疗的新冠肺炎患者,DVT的发生率高,且与预后不良相关。静脉血栓形成的预防对Padua预测得分≥4分的患者具有保护作用。本研究提示COVID-19可能是住院患者发生DVT的额外风险因素。

原始出处:

Li Zhang,et al. Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China. Circulation. 2020;142:114–128

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    2020-11-17 ms6000001502154832

    高效

    0

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    2020-11-04 xue8602
  4. [GetPortalCommentsPageByObjectIdResponse(id=1698122, encodeId=d3c2169812295, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sat Nov 14 19:44:56 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899749, encodeId=99ac899e49cb, content=高效, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96c35432713, createdName=ms6000001502154832, createdTime=Tue Nov 17 00:31:05 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955499, encodeId=40851955499d3, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Nov 04 15:44:56 CST 2020, time=2020-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813645, encodeId=921c81364531, content=及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 07:10:17 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803600, encodeId=01418036007a, content=<a href='/topic/show?id=8f0d66169f9' target=_blank style='color:#2F92EE;'>#深静脉血栓#</a>新冠是血管病, beContent=null, objectType=article, channel=null, level=null, likeNumber=195, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66169, encryptionId=8f0d66169f9, topicName=深静脉血栓)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 00:26:35 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803124, encodeId=aa1780312467, content=这是否与重症患者缺少下肢活动造成更易引起血栓, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03ad5255237, createdName=147edfdfm03暂无昵称, createdTime=Fri Jul 17 17:52:18 CST 2020, time=2020-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028306, encodeId=fe40102830673, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Fri Jul 17 17:44:56 CST 2020, time=2020-07-17, status=1, ipAttribution=)]
    2020-08-27 14818eb4m67暂无昵称

    及时

    0

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    2020-07-21 lovetcm

    #深静脉血栓#新冠是血管病

    0

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    2020-07-17 147edfdfm03暂无昵称

    这是否与重症患者缺少下肢活动造成更易引起血栓

    0

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    2020-07-17 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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