在深静脉血栓形成后,出现中度至重度的血栓后综合征的非常长期风险
Jean-Philippe Galanaud1, Lila Krebs-Drouot2, Céline Genty-Vermorel2
1Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada.
Journal of thrombosis and haemostasis : JTH
|August 9, 2024
概括
血栓后综合征 (PTS) 影响四分之一的患者深静脉血栓症 (DVT) 后很长时间. 虽然DVT有助于PTS,但其影响因DVT程度而异,远距离DVT没有显著增加风险.
科学领域:
- 血管医学 血管医学
- 血栓形成研究研究
- 临床流行病学临床流行病学
背景情况:
- 血栓后综合征 (PTS) 涵盖了深静脉血栓症 (DVT) 后的慢性静脉功能不全.
- 长期风险和DVT程度对中度至重度PTS的具体影响仍未得到充分探索.
- 对DVT与其他慢性静脉不全导致长期PTS表现的贡献尚不清楚.
研究的目的:
- 为了确定深静脉血栓形成后发展中度至严重的血栓后综合征的长期风险.
- 评估深静脉血栓症在血栓后综合征症状的发展中的病因作用.
主要方法:
- 从OPTIMEV研究中对患有下肢深静脉血栓症的患者进行了非常长期的电话随访.
- 通过患者报告的Villalta得分来评估中度至重度PTS的比例,根据DVT程度进行分析.
- 计算了中度至重度PTS表现的DVT在人口中可归因的比例.
主要成果:
- 在DVT发生14年后,中度至重度的PTS发生在18.9%的远距离DVT病例中,23.4%的脊椎DVT病例中,和36.5%的脊椎骨上DVT病例中.
- 在中度至重度的PTS症状中,DVT在人群中可归因的比例从25.7% (距离性DVT) 到43.1% (阴性DVT) 不等.
- 远端DVT并没有显著提高中度至重度PTS发展的风险.
结论:
- 大约25%的患者经历了深静脉血栓形成后的非常长期中度至严重的血栓后综合征表现.
- 深静脉血栓症对这些表现的影响并不占主导地位,并且取决于初始DVT的程度.
- 距离深静脉血栓形成似乎不会显著增加患中度至重度血栓后综合征的风险.
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