Caprini量表评估老年糖尿病病人静脉血栓栓塞症的效果

doi:10.3969/j.issn.1003-9198.2023.12.011

摘要/Abstract

摘要： 目的分析Caprini量表评估老年糖尿病病人静脉血栓栓塞症(VTE)的效果及老年糖尿病病人发生VTE的危险因素。方法收集2017年1月至2021年9月在四川大学华西医院住院治疗的1573例老年糖尿病病人的病历资料,将其中确诊为VTE的306例病人设为血栓组,未确诊VTE的1267例病人设为非血栓组。比较2组Caprini量表评分及危险度分级。单因素分析2组基线资料及Caprini量表中的风险因素。采用多因素Logistic回归模型分析老年糖尿病病人发生VTE的影响因素。结果血栓组的Caprini量表评分明显高于非血栓组,Caprini量表分级为高危病人比例显著高于非血栓组(均P＜0.01)。单因素分析结果显示,2组在D-二聚体、FPG水平,严重的肺部疾病、肺功能异常、大手术(＞45 min)、转氨酶增高、卧床的内科病人比例方面差异有统计学意义(P＜0.05或P＜0.01)。多因素Logistic回归分析结果显示,肺功能异常、大手术(＞45 min)、卧床的内科病人、D-二聚体、FPG是老年糖尿病病人并发VTE的独立影响因素。结论 Caprini量表可用于评估老年糖尿病病人VTE的发病风险,但Caprini量表中缺乏血糖等可能引起老年糖尿病病人血栓的风险因素,未来仍需构建专门用于老年糖尿病病人的简单、易开展的血栓评估量表。

关键词: 老年人, 糖尿病, 静脉血栓栓塞症, Caprini量表

Abstract: Objective To analyze the assessment effect of Caprini scale on venous thromboembolism (VTE) in the elderly patients with diabetes and the risk factors of the incidence of VTE. Methods The clinical data of 1573 elderly patients with diabetes who were hospitalized at West China Hospital, Sichuan University from January 2017 to September 2021 were collected. Among them, 306 patients presenting with VTE were assigned to the VTE group, while 1267 patients without VTE were assigned to the non-VTE group. The score and risk stratification of Caprini scale were compared between the two groups. Univariate analysis and Multivariate Logistic regression analysis were used to analyze the influencing factors for VTE in the elderly patients with diabetes. Results The score and the proportion of high-risk patients in the VTE group were significantly higher than those in the non-VTE group (all P<0.01). Univariate analysis showed that there were statistically significant differences in the levels of D-dimer and fasting plasma glucose (FPG), the proportion of severe pulmonary disease, abnormal lung function, major surgery (>45 min), elevated transaminase, and bedridden patients of Internal Medicine between the two groups (P<0.05 or P<0.01). Multivariate Logistic regression analysis showed that abnormal lung function, major surgery (>45 min), bedridden patients of Internal Medicine, D-dimer and FPG were the independent influencing factors for VTE in the elderly patients with diabetes. Conclusions Caprini scale can be used to assess the risk of VTE in the elderly patients with diabetes. However, Caprini scale lacks blood glucose. In the future, it is necessary to develop a simple and easy thrombosis assessment scale for the elderly patients with diabetes.

Key words: aged, diabetes, venous thromboembolism, Caprini scale

中图分类号:

范婷泳, 袁丽, 杨小玲, 陈茜. Caprini量表评估老年糖尿病病人静脉血栓栓塞症的效果[J]. 实用老年医学, 2023, 37(12): 1233-1237.

FAN Ting-yong, YUAN Li, YANG Xiao-ling, CHEN Qian. Assessment effect of Caprini scale on venous thromboembolism in elderly patients with diabetes[J]. Practical Geriatrics, 2023, 37(12): 1233-1237.

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