Lancet Haematol：与NICU的重症新生儿动静脉血栓形成相关的风险因素！

2022-02-11 Nebula MedSci原创

多种危险因素均可增加重症新生儿动静脉血栓形成风险！

由于多种危险因素，重症婴儿易发生血栓形成。本研究目的是明确与新生儿重症监护室（NICU）的新生儿静脉和动脉血栓形成相关的危险因素，同时分析静脉血栓与动脉血栓形成危险因素的差异。

这是一项病例对照研究，数据来源于2010年1月1日-2016年12月13日期间美国儿童医院新生儿数据库。根据静脉或动脉血栓形成的结果确定病例，匹配胎龄、中央接入设备 (CAD)、医院和入院年份相同的对照。入组病例：对照=1 : 4。

共鉴定了31个NICU收治的118952名新生儿。总的血栓形成发生率为15.5/1000名NICU新生儿。排除了住院时间超过 3 天或患有心脏病的患儿后，该研究分析纳入了1326例血栓形成病例（1022例静脉血栓形成，362例动脉血栓形成；58例同时存在静脉和动脉血栓形成）和5304名随机选择的对照。

与静脉血栓形成的风险因素

静脉血栓形成与血液感染（优势比 2.07，p<0.0001）、母亲糖尿病（1.62，p<0.0001）、腹部或胃肠道手术（1.36，p<0.0001）、血小板减少症（2.44，p<0.0001）、长时间机械通气（1.27，p=0.0014）和进NICU时出生7天及以上（1.49，p<0.0001）独立相关。

与动脉血栓形成的风险因素

动脉血栓形成与母亲高血压（1.42，p=0.030）、血小板减少症（2.20，p<0.0001）、长时间机械通气（1.58，p=0.0002）、进NICU时出生7天及以上（1.35，p=0.0018）和小于出生胎龄（1.56，p=0.0003）独立相关。

在中央接入设备 (CAD) 亚组分析中，CAD使用持续21天及以上（静脉血栓形成：OR 1.52, p=0.0034; 动脉血栓形成：1.98，p=0.035）和上下身同时接入CAD（静脉血栓形成：OR 2.43, p<0.0001; 动脉血栓形成：1.58，p=0.040）与血栓形成风险增加相关。

总之，明确血栓形成相关的风险因素将有助于开发风险预测模型以预防血栓形成和改善重症新生儿的预后。该研究结果增加了对新生儿静脉和动脉血栓形成危险因素差异的认识，并加深了对CAD使用与新生儿血栓形成关联的理解。

原始出处：

Rukhmi Bhat, et al. Risk factors associated with venous and arterial neonatal thrombosis in the intensive care unit: a multicentre case-control study. The Lancet Hematology. February 08, 2022. https://doi.org/10.1016/S2352-3026(21)00399-9.

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2022-05-18 xue8602

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topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Tue Oct 04 00:08:51 CST 2022, time=2022-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201981, encodeId=0755120198167, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/wrK88GbrwEH7IX8Qn6JNW417PI4aA1anS5cHVdzQnhC03fef3DsbXtkdx0a84diaAztGjAJlnOsiaqiaYDW2ibK8iaw/132, createdBy=ecbc5135505, createdName=13746658d9m, createdTime=Sat Mar 12 13:09:31 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1194043, encodeId=e5651194043c0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-10-04 changfy

#HAE#

30 0
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topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590727, encodeId=ce4f1590e2755, content=<a href='/topic/show?id=9e7c12e9608' target=_blank style='color:#2F92EE;'>#NICU#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12796, encryptionId=9e7c12e9608, topicName=NICU)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd9917855235, createdName=zhangjiqing, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192382, encodeId=be1f1192382ea, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-03-12 13746658d9m

学习了

0 0
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channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-02-16 ms7347495599973477

学习了

52 0
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topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Tue Oct 04 00:08:51 CST 2022, time=2022-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201981, encodeId=0755120198167, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/wrK88GbrwEH7IX8Qn6JNW417PI4aA1anS5cHVdzQnhC03fef3DsbXtkdx0a84diaAztGjAJlnOsiaqiaYDW2ibK8iaw/132, createdBy=ecbc5135505, createdName=13746658d9m, createdTime=Sat Mar 12 13:09:31 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1194043, encodeId=e5651194043c0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-02-12 fengyi812

#EMA#

28 0
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createdName=howi, createdTime=Mon Sep 26 04:08:51 CST 2022, time=2022-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955577, encodeId=621b19555e73c, 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=31, 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 May 18 14:08:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008562, encodeId=edb420085625d, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Tue Oct 04 00:08:51 CST 2022, time=2022-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201981, encodeId=0755120198167, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/wrK88GbrwEH7IX8Qn6JNW417PI4aA1anS5cHVdzQnhC03fef3DsbXtkdx0a84diaAztGjAJlnOsiaqiaYDW2ibK8iaw/132, createdBy=ecbc5135505, createdName=13746658d9m, createdTime=Sat Mar 12 13:09:31 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1194043, encodeId=e5651194043c0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30941809916, createdName=ms7347495599973477, createdTime=Wed Feb 16 15:12:42 CST 2022, time=2022-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317692, encodeId=8d66131e692af, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483309, encodeId=236114833099d, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590727, encodeId=ce4f1590e2755, content=<a href='/topic/show?id=9e7c12e9608' target=_blank style='color:#2F92EE;'>#NICU#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12796, encryptionId=9e7c12e9608, topicName=NICU)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd9917855235, createdName=zhangjiqing, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192382, encodeId=be1f1192382ea, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-02-12 ms5187542471278033

#静脉血栓形成#

43 0
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createdName=howi, createdTime=Mon Sep 26 04:08:51 CST 2022, time=2022-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955577, encodeId=621b19555e73c, 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=31, 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 May 18 14:08:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008562, encodeId=edb420085625d, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Tue Oct 04 00:08:51 CST 2022, time=2022-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201981, encodeId=0755120198167, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/wrK88GbrwEH7IX8Qn6JNW417PI4aA1anS5cHVdzQnhC03fef3DsbXtkdx0a84diaAztGjAJlnOsiaqiaYDW2ibK8iaw/132, createdBy=ecbc5135505, createdName=13746658d9m, createdTime=Sat Mar 12 13:09:31 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1194043, encodeId=e5651194043c0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30941809916, createdName=ms7347495599973477, createdTime=Wed Feb 16 15:12:42 CST 2022, time=2022-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317692, encodeId=8d66131e692af, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483309, encodeId=236114833099d, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590727, encodeId=ce4f1590e2755, content=<a href='/topic/show?id=9e7c12e9608' target=_blank style='color:#2F92EE;'>#NICU#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12796, encryptionId=9e7c12e9608, topicName=NICU)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd9917855235, createdName=zhangjiqing, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192382, encodeId=be1f1192382ea, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-02-12 zhangjiqing

#NICU#

29 0
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createdName=howi, createdTime=Mon Sep 26 04:08:51 CST 2022, time=2022-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955577, encodeId=621b19555e73c, 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=31, 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 May 18 14:08:51 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008562, encodeId=edb420085625d, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Tue Oct 04 00:08:51 CST 2022, time=2022-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201981, encodeId=0755120198167, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/wrK88GbrwEH7IX8Qn6JNW417PI4aA1anS5cHVdzQnhC03fef3DsbXtkdx0a84diaAztGjAJlnOsiaqiaYDW2ibK8iaw/132, createdBy=ecbc5135505, createdName=13746658d9m, createdTime=Sat Mar 12 13:09:31 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1194043, encodeId=e5651194043c0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30941809916, createdName=ms7347495599973477, createdTime=Wed Feb 16 15:12:42 CST 2022, time=2022-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317692, encodeId=8d66131e692af, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483309, encodeId=236114833099d, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590727, encodeId=ce4f1590e2755, content=<a href='/topic/show?id=9e7c12e9608' target=_blank style='color:#2F92EE;'>#NICU#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12796, encryptionId=9e7c12e9608, topicName=NICU)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd9917855235, createdName=zhangjiqing, createdTime=Sat Feb 12 13:08:51 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192382, encodeId=be1f1192382ea, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210612/4cac76eb29134c3aa63a2560971ec878/648fa1cb22cd430380c051eb0a8f6259.jpg, createdBy=7a8d5519826, createdName=呼吸科小医生, createdTime=Fri Feb 11 16:56:58 CST 2022, time=2022-02-11, status=1, ipAttribution=)]
2022-02-11 呼吸科小医生

谢谢分享

47 0

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