老年人深静脉血栓的流行病学与危险因素研究进展

doi:10.3969/j.issn.1003-9198.2025.09.004

摘要/Abstract

摘要： 深静脉血栓(deep venous thrombosis, DVT)作为一种常见且具有潜在威胁的疾病,在老年人群中尤为显著。DVT的危险因素复杂多样,包括与年龄相关的血管条件和凝血功能的变化,以及多种慢性疾病,如高血压、糖尿病、肾病和恶性肿瘤等,均显著增加DVT发生的可能性。另外,老年人群由于机体老化,活动能力降低,若合并脑卒中、神经认知功能障碍、骨折等,长期坐位或卧床缺乏运动,使得下肢静脉血流缓慢或瘀滞,易形成DVT。本文回顾总结老年病人发生DVT的流行病学特征以及危险因素,以期帮助临床制定更为适宜的治疗方案及预防措施,保护老年人群的生命健康。

关键词: 深静脉血栓, 老年人, 流行病学, 危险因素

Abstract: Deep venous thrombosis (DVT) is a common and potentially threatening disease, particularly in older people. Risk factors for DVT are complex and diverse, including age-related changes in vascular conditions and coagulation function, as well as a variety of chronic diseases such as hypertension, diabetes, kidney disease, and malignancy, all of which significantly increase the likelihood of developing DVT. In addition, due to the aging of the body, the elderly have reduced mobility, if combined with stroke, neurocognitive dysfunction and fracture, with limited activities, long-term sitting or bed and lack of exercise, resulting in DVT due to slow venous flow of the lower limbs, blood stasis. This article reviews and summarizes the epidemiological characteristics and risk factors of DVT in elderly patients, which is helpful for formulating more appropriate treatment plans and preventive measures to protect the life and health of the elderly.

Key words: deep venous thrombosis, aged, epidemiology, risk factor

中图分类号:

R 543.6

杜海雯, 张一丹, 李霞, 刘姣, 魏淑萍. 老年人深静脉血栓的流行病学与危险因素研究进展[J]. 实用老年医学, 2025, 39(9): 879-882.

DU Haiwen, ZHANG Yidan, LI Xia, LIU Jiao, WEI Shuping. Advances in the epidemiology and risk factors of deep venous thrombosis in the elderly[J]. Practical Geriatrics, 2025, 39(9): 879-882.

参考文献

[1] WOLF S, BARCO S, DI NISIO M, et al. Epidemiology of deep vein thrombosis[J]. Vasa, 2024, 53(5): 298-307.
[2] 王永刚, 付凯, 郑伟, 等. 老年股骨颈骨折围术期下肢深静脉血栓形成危险因素分析[J]. 中国修复重建外科杂志, 2024, 38(11): 1336-1339.
[3] 伍正根, 徐伟, 王自鸿, 等. 老年髋部骨折围手术期深静脉血栓形成的发生规律及血浆D-二聚体、纤维蛋白原的诊断价值[J]. 实用老年医学, 2019, 33(8): 783-787.
[4] 王锐, 王翔弘, 李旭斌. 老年急腹症患者住院期间发生下肢深静脉血栓的危险因素分析[J]. 血管与腔内血管外科杂志, 2024, 10(8): 920-924.
[5] 平方芳, 付新鸽, 李艺博. 老年肺癌患者下肢深静脉血栓形成情况及其影响因素分析[J]. 实用癌症杂志, 2024, 39(4): 612-614, 619.
[6] 徐叶亮. 不同年龄段下肢深静脉血栓形成患者的临床特征及预后分析[D]. 重庆: 重庆医科大学, 2024.
[7] NAESS I A, CHRISTIANSEN S C, ROMUNDSTAD P, et al. Incidence and mortality of venous thrombosis: a population-based study[J]. J Thromb Haemost, 2007, 5(4): 692-699.
[8] BARCO S, KLOK F A, MAHÉ I, et al. Impact of sex, age, and risk factors for venous thromboembolism on the initial presentation of first isolated symptomatic acute deep vein thrombosis[J]. Thromb Res, 2019, 173: 166-171.
[9] AGENO W, HAAS S, WEITZ J I, et al. Characteristics and management of patients with venous thromboembolism: the GARFIELD-VTE registry[J]. Thromb Haemost, 2019, 119(2): 319-327.
[10] NAWASRAH J, ZYDEK B, LUCKS J, et al. Incidence and severity of postthrombotic syndrome after iliofemoral thrombosis-results of the Iliaca-PTS-Registry[J]. Vasa, 2021, 50(1): 30-37.
[11] GONG S, LEE E J, KIM J S, et al. Association between laterality and location of deep vein thrombosis of lower extremity and pulmonary embolism[J]. Vasc Specialist Int, 2021, 37: 12.
[12] SIEGAL D M, EIKELBOOM J W, LEE S F, et al. Variations in incidence of venous thromboembolism in low-, middle-, and high-income countries[J]. Cardiovasc Res, 2021, 117(2): 576-584.
[13] DELLUC A, TROMEUR C, LE VEN F, et al. Current incidence of venous thromboembolism and comparison with 1998: a community-based study in Western France[J]. Thromb Haemost, 2016, 116(5): 967-974.
[14] WANG H, ROSENDAAL F R, CUSHMAN M, et al. Association between cardiovascular risk factors and venous thromboembolism in the elderly[J]. Res Pract Thromb Haemost, 2022, 6(2): e12671.
[15] OGUNDEJI S P, FASOLA F A, KOTILA T R. Hypertension and diabetes mellitus are associated with deep venous thromboembolism: a case control study[J]. Ann Ib Postgrad Med, 2024, 22(1): 34-38.
[16] WHITE R H, ZHOU H, ROMANO P S. Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures[J]. Thromb Haemost, 2003, 90(3): 446-455.
[17] MULDER F I, HORVÁTH-PUHÓ E, VAN ES N, et al. Venous thromboembolism in cancer patients: a population-based cohort study[J]. Blood, 2021, 137(14): 1959-1969.
[18] KELLER K, KOHRING C, FARMAKIS I T, et al. Impact of venous thromboembolism on incidence of arterial thromboembolism - an analysis of German outpatient claims data[J]. Thromb Res, 2023, 226: 9-17.
[19] ENGBERS M J, VAN HYLCKAMA VLIEG A, ROSENDAAL F R. Venous thrombosis in the elderly: incidence, risk factors and risk groups[J]. J Thromb Haemost, 2010, 8(10): 2105-2112.
[20] AMARAL F C, BAPTISTA-SILVA J C, NAKANO L C, et al. Pharmacological interventions for preventing venous thromboembolism in people undergoing bariatric surgery[J]. Cochrane Database Syst Rev, 2022, 11(11): CD013683.
[21] KLOK F A, AGENO W, AY C, et al. Optimal follow-up after acute pulmonary embolism: a position paper of the European Society of Cardiology Working Group on Pulmonary Circulation and Right Ventricular Function, in collaboration with the European Society of Cardiology Working Group on Atherosclerosis and Vascular Biology, endorsed by the European Respiratory Society[J]. Eur Heart J, 2022, 43(3): 183-189.
[22] MA Y, LIU Y, ZHI Y, et al. Risk factors of pulmonary embolism in the elderly patients: a retrospective study[J]. Aging Clin Exp Res, 2022, 34(5): 1133-1137.
[23] AMBROSINO P, BACHETTI T, D’ANNA S E, et al. Mechanisms and clinical implications of endothelial dysfunction in arterial hypertension[J]. J Cardiovasc Dev Dis, 2022, 9(5): 136.
[24] KOUTROUMPAKIS E, DESWAL A, YUSUF S W, et al. Radiation-induced cardiovascular disease: mechanisms, prevention, and treatment[J]. Curr Oncol Rep, 2022, 24(5): 543-553.
[25] HEIT J A, SPENCER F A, WHITE R H. The epidemiology of venous thromboembolism[J]. J Thromb Thrombolysis, 2016, 41(1): 3-14.
[26] SPIEZIA L, CAMPELLO E, SIMION C, et al. Risk factors for post-thrombotic syndrome in patients with a first proximal deep venous thrombosis treated with direct oral anticoagulants[J]. Angiology, 2022, 73(7): 649-654.
[27] RYAN L, MATARASO S, SIEFKAS A, et al. A machine learning approach to predict deep venous thrombosis among hospitalized patients[J]. Clin Appl Thromb Hemost, 2021, 27: 1076029621991185.