Tan Ker-Kan, Koh Woon-Puay, Chao Alexandre K H
Department of Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng Road, Singapore 308433.
Ann Vasc Surg. 2007 Jul;21(4):490-5. doi: 10.1016/j.avsg.2006.06.008. Epub 2007 Feb 26.
Deep venous thrombosis (DVT) is perceived to occur less frequently among Asians than Caucasians, although the reason for this has not been fully understood. Hence, there may be differences in risk factors and presentations among Asian patients compared to their Caucasian counterparts. This study examined the association of classical risk factors and presentations among Asian patients with DVT. We retrospectively reviewed 862 symptomatic patients referred to the vascular diagnostic laboratory in a hospital for suspected DVT over a 30-month period. Two hundred and seventy-seven patients (32.1%) tested positive for DVT on duplex ultrasound. After adjusting for age and gender, ethnicity was not a statistically significant demographic factor associated with DVT. Two hundred and seventy-one patients diagnosed as having DVT on ultrasound were matched for age, gender, and ethnicity to negative controls to study the significance of risk factors and presenting symptoms or signs. In multivariate analysis, independent risk factors for DVT included immobility (odds ratio [OR] = 2.61, 95% confidence interval [95% CI] 1.63-4.15], malignancy (OR = 1.77, 95% CI 1.01-3.10), and a history of thrombophilia (OR = 9.95, 95% CI 1.26-78.87). The significant forms of DVT presentation were limb swelling (OR = 2.53, 95% CI 1.41-4.54) and pulmonary embolism (OR = 11.45, 95% CI 3.23-40.59). Fever of more than 37.5 degrees C was a negative predictive factor (OR = 0.42, 95% CI 0.23-0.76). This study shows that the common risk factors of DVT such as surgery and fractures do not affect Asians as much as Caucasians. Instead, thrombophilia and underlying malignancy are prominent risk factors among Asians. Diagnosis of DVT in Asians based on clinical grounds can also be problematic as few presentations are specific.
尽管亚洲人深静脉血栓形成（DVT）的发生率低于白种人，但尚未完全明确其原因。因此，与白种人相比，亚洲患者的危险因素和临床表现可能存在差异。本研究探讨了亚洲DVT患者的经典危险因素与临床表现之间的关联。我们回顾性分析了一家医院血管诊断实验室在30个月内收治的862例疑似DVT的有症状患者。277例患者（32.1%）经双功超声检查DVT呈阳性。校正年龄和性别后，种族不是与DVT相关的具有统计学意义的人口统计学因素。将271例经超声诊断为DVT的患者按年龄、性别和种族与阴性对照进行匹配，以研究危险因素及症状或体征的意义。多因素分析显示，DVT的独立危险因素包括活动减少（比值比[OR]=2.61，95%置信区间[95%CI]1.63 - 4.15）、恶性肿瘤（OR = 1.77，95%CI 1.01 - 3.10）和血栓形成倾向病史（OR = 9.95，95%CI 1.26 - 78.87）。DVT的显著表现形式为肢体肿胀（OR = 2.53，95%CI 1.41 - 4.54）和肺栓塞（OR = 11.45，95%CI 3.23 - 40.59）。体温高于37.5℃是一个阴性预测因素（OR = 0.42，95%CI 0.23 - 0.76）。本研究表明，手术和骨折等DVT常见危险因素对亚洲人的影响不如对白种人大。相反，血栓形成倾向和潜在恶性肿瘤是亚洲人中突出的危险因素。由于很少有临床表现具有特异性，基于临床依据诊断亚洲人的DVT也可能存在问题。
