Kawase Kayoko, Okazaki Shuhei, Toyoda Kazunori, Toratani Naomi, Yoshimura Sohei, Kawano Hiroyuki, Nagatsuka Kazuyuki, Matsuo Hiroshi, Naritomi Hiroaki, Minematsu Kazuo
Department of Medicine, Cerebrovascular Division, National Cardiovascular Center, Suita, Japan.
Cerebrovasc Dis. 2009;27(4):313-9. doi: 10.1159/000202006. Epub 2009 Feb 14.
Stroke patients often develop deep-vein thrombosis (DVT), a potential cause of pulmonary thromboembolism. Little information is available on DVT in Asian patients with intracerebral hemorrhage (ICH).
We prospectively enrolled consecutive acute ICH patients. The main exclusion criteria were neurosurgical treatment, early death and coagulation disorders. DVT was evaluated using venous duplex ultrasonography on the day of admission, as well as 7 and 14 days later. Underlying characteristics, stroke features and laboratory data on admission were compared between patients who developed DVT by 14 days and those who did not.
A total of 81 (50 men, mean age 65 years, median NIH Stroke Scale, NIHSS, score 12) of 117 Japanese ICH patients were enrolled. DVT was detected in 4 patients on admission and was newly detected in 9 at 7 days. By 14 days, 17 patients (21%) were diagnosed as having DVT without thromboembolic complications, although 1 patient developed pulmonary thromboembolism. DVT was detected in the soleal veins of all 17 patients, followed by the peroneal veins (7 patients). After adjustment for age and related confounders, female sex was the only independent predictor for DVT (odds ratio 6.89, 95% confidence interval, CI, 1.56-36.34, p = 0.014). Female patients with an initial NIHSS score > or =12 had 19 times the risk for DVT compared to men with an NIHSS score <12 (95% CI 2.61-213.77, p = 0.007).
DVT formation was not rare in Japanese ICH patients. Contrary to previous findings reported from western countries, female sex was strongly associated with DVT formation.
中风患者常发生深静脉血栓形成（DVT），这是肺血栓栓塞的一个潜在原因。关于亚洲脑出血（ICH）患者深静脉血栓形成的信息较少。
我们前瞻性地纳入了连续的急性脑出血患者。主要排除标准为神经外科治疗、早期死亡和凝血障碍。在入院当天以及7天和14天后使用静脉双重超声评估深静脉血栓形成。比较了在14天内发生深静脉血栓形成的患者和未发生深静脉血栓形成的患者的基础特征、中风特征和入院时的实验室数据。
117例日本脑出血患者中共有81例（50例男性，平均年龄65岁，美国国立卫生研究院卒中量表[NIHSS]中位数评分12分）被纳入研究。入院时在4例患者中检测到深静脉血栓形成，7天时又新发现9例。到14天时，17例患者（21%）被诊断为患有深静脉血栓形成且无血栓栓塞并发症，尽管有1例患者发生了肺血栓栓塞。17例患者中所有患者的比目鱼肌静脉均检测到深静脉血栓形成，其次是腓静脉（7例患者）。在调整年龄和相关混杂因素后，女性是深静脉血栓形成的唯一独立预测因素（比值比6.89，95%置信区间[CI]1.56 - 36.34，p = 0.014）。初始NIHSS评分≥12分的女性患者发生深静脉血栓形成的风险是NIHSS评分<12分男性患者的19倍（95%CI 2.61 - 213.77，p = 0.007）。
深静脉血栓形成在日本脑出血患者中并不罕见。与西方国家先前报道的结果相反，女性与深静脉血栓形成密切相关。
