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神经重症缺血性脑卒中患者下肢深静脉血栓形成与平衡功能的关联

Association between lower extremity deep vein thrombosis and balance function in patients with neurocritical ischemic stroke

    摘要
  • 摘要:
    目的 探讨神经重症缺血性脑卒中患者下肢深静脉血栓形成(DVT)与平衡功能的关联。
    方法 回顾性分析308例神经重症缺血性脑卒中患者的临床资料，根据是否发生下肢DVT将患者分为DVT组和无DVT组。比较2组患者的临床资料，分析神经重症缺血性脑卒中患者发生下肢DVT的独立影响因素，并采用Point-biserial相关分析评估相关性。
    结果 308例患者中, 142例(46.10%)发生下肢DVT。与无DVT组(n=166)相比，DVT组(n=142)患者入院后卧床时间、凝血酶时间(TT)更长, D-二聚体、血小板(PLT)计数、纤维蛋白原(FIB)水平、美国国立卫生研究院卒中量表(NIHSS)评分及年龄≥65岁、体质量指数(BMI)>24 kg/m2、合并高脂血症、合并糖尿病者占比更高, Berg平衡量表(BBS)评分更低, 差异有统计学意义(P < 0.05)。经多重共线性诊断后，多因素Logistic回归分析结果显示，入院后卧床时间长、D-二聚体水平高、PLT高、FIB水平高、TT延长、NIHSS评分高、年龄≥65岁、BMI>24 kg/m2、合并高脂血症、合并糖尿病均为神经重症缺血性脑卒中患者下肢DVT发生的独立危险因素(P < 0.05), BBS评分高则为独立保护因素(P < 0.05)。Point-biserial相关分析结果显示，入院后卧床时间、D-二聚体、PLT、FIB、TT、NIHSS评分均与神经重症缺血性脑卒中患者下肢DVT发生风险呈正相关(P < 0.05), BBS评分则与下肢DVT发生风险呈负相关(P < 0.05)。
    结论 年龄、BMI、入院后卧床时间、凝血功能、脑卒中严重程度、平衡功能均与神经重症缺血性脑卒中患者下肢DVT的发生存在密切关联。

     

    Abstract:
    Objective To explore the association between lower extremity deep vein thrombosis (DVT) and balance function in patients with neurocritical ischemic stroke.
    Methods The clinical data of 308 patients with neurocritical ischemic stroke were retrospectively analyzed. The patients were divided into DVT group and non-DVT group according to whether lower extremity DVT occurred. The clinical data of the two groups were compared, and the independent influencing factors for the occurrence of lower extremity DVT in patients with neurocritical ischemic stroke were analyzed. Point-biserial correlation analysis was used to evaluate the correlations.
    Results Among the 308 patients, 142 (46.10%) developed lower extremity DVT. Compared with the non-DVT group (n=166), patients in the DVT group (n=142) had longer bed-rest time after admission and longer thrombin time (TT). They also had higher levels of D-dimer, platelet (PLT) count, fibrinogen (FIB), higher scores on the National Institutes of Health Stroke Scale (NIHSS), and a higher proportion of patients aged≥65 years, with a body mass index (BMI)>24 kg/m2, complicated with hyperlipidemia, and complicated with diabetes. Their Berg Balance Scale (BBS) scores were lower, and the differences were statistically significant (P < 0.05). After multicollinearity diagnosis, the results of multivariate logistic regression analysis showed that long bed-rest time after admission, high D-dimer level, high PLT count, high FIB level, prolonged TT, high NIHSS score, age≥65 years, BMI>24 kg/m2, complicated with hyperlipidemia, and complicated with diabetes were all independent risk factors for the occurrence of lower extremity DVT in patients with neurocritical ischemic stroke (P < 0.05), while a high BBS score was an independent protective factor (P < 0.05). The results of Point-biserial correlation analysis showed that bed-resttime after admission, D-dimer, PLT, FIB, TT, and NIHSS score were all positively correlated with the risk of lower extremity DVT in patients with neurocritical ischemic stroke (P < 0.05), while the BBS score was negatively correlated with the risk of lower extremity DVT (P < 0.05).
    Conclusion Age, BMI, bed-rest time after admission, coagulation function, stroke severity, and balance function are all closely associated with the occurrence of lower extremity DVT in patients with neurocritical ischemic stroke.

     

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