Circulation:COVID-19住院患者深静脉血栓形成的患病率、危险因素和结局

2020-05-23 MedSci原创 MedSci原创

COVID-19住院患者DVT的患病率很高,并且与其不良结局有关。入院后帕多瓦预测评分≥4的患者接受预防静脉血栓栓塞治疗具有保护性效应。该研究的数据表明COVID-19可能是住院患者发生DVT的一个危

为了探究住院的2019冠状病毒病(COVID-19)患者深静脉血栓形成(DVT),近日,心血管领域权威杂志Circulation上发表了一篇研究文章,研究人员进行了一项单中心研究,以评估COVID-19患者DVT的患病率、危险因素、预后以及潜在的血栓预防策略。

研究人员对2020年1月29日至2月29日期间住院的143例COVID-19患者进行了分析,并获得了受试者人口统计学和临床数据、实验室检查数据(包括下肢超声扫描)和结局变量,并对DVT组和非DVT组进行了比较。

在143例COVID-19住院患者(年龄为63±14岁;74名[51.7%]男性)中,有66例患者发展为下肢DVT(46.1%,包括23例[34.8%]伴有近端DVT和43例[65.2%])远端DVT)。与没有DVT的患者相比,DVT的患者年龄更大,氧合指数更低,心脏损伤率更高,预后更差,包括死亡比例增加(23 [34.8%] vs. 9 [11.7%],P=0.001)和出院患者比例下降(32 [48.5%] vs. 60 [77.9%],P<0.001)。多变量分析仅显示CURB-65评分3-5(OR=6.122,P=0.031)、帕多瓦预测得分≥4(OR=4.016,P=0.04)和D-二聚体>1.0(μg/ml)(OR=5.818,P<0.014)与DVT之间存在关联。CURB-65评分3-5、帕多瓦预测评分≥4和D-二聚体>1.0(μg/ml)组合一起来筛查DVT,其敏感性为88.52%,特异性为61.43%。在入院后72小时内进行了超声扫描且帕多瓦预测评分≥4的患者亚组中,接受静脉血栓栓塞预防组中有18例(34.0%)发生了DVT,而非预防组则有35例(63.3%)发生了DVT(P=0.010)。

由此可见,COVID-19住院患者DVT的患病率很高,并且与其不良结局有关。入院后帕多瓦预测评分≥4的患者接受预防静脉血栓栓塞治疗具有保护性效应。该研究的数据表明COVID-19可能是住院患者发生DVT的一个危险因素。

原始出处:

Li Zhang,et al.Deep Vein Thrombosis in Hospitalized Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: Prevalence, Risk Factors, and Outcome. Circulation.2020.https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.046702

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    2021-04-03 fusion
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    2020-12-01 xue8602
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