Delluc A, Gouedard C, De Saint Martin L, Garcia C, Roguedas A-M, Bressollette L, Misery L, Mottier D, Le Gal G
Université européenne de Bretagne, 29238 Brest cedex 3, France.
Rev Med Interne. 2010 Nov;31(11):729-34. doi: 10.1016/j.revmed.2010.07.018. Epub 2010 Sep 29.
Despite appropriate therapy 10 to 100% of patients with deep vein thrombosis (DVT) of the lower limbs will develop post-thrombotic syndrome (PTS). The aim of this study was to evaluate the incidence of PTS in the EDITH cohort and to estimate the association between initial patients' characteristics and the risk of development of PTS.
One hundred and eighty patients included in the EDITH study for a first event of DVT of the lower limbs without clinical signs of venous insufficiency were recalled 4 years after their initial thrombotic event. PTS was diagnosed according to the Villalta score.
Ninety-five patients (45 men, mean age 50.7 ± 16.9 years) were evaluated for PTS. Among them, 28.4% (95% CI 19.3-37.5) developed PTS but none had severe PTS. The most frequent clinical signs of PTS were varicose veins (59%), corona phlebectatica (48%), swelling leg (30%) and pigmented dermatitis (26%). No single risk factor was associated with PTS development (age, sex, BMI thrombophilia, etiology, localization, recurrence, symptomatic DVT and familial history of DVT).
PTS is a frequent disease. However, lack of uniformity of diagnosis criteria in the different studies does not make possible the estimation of PTS risk factors.
尽管进行了适当治疗,但10%至100%的下肢深静脉血栓形成(DVT)患者仍会发生血栓后综合征(PTS)。本研究的目的是评估EDITH队列中PTS的发生率,并估计初始患者特征与PTS发生风险之间的关联。
对纳入EDITH研究的180例首次发生下肢DVT且无静脉功能不全临床体征的患者,在其首次血栓形成事件4年后进行随访。根据Villalta评分诊断PTS。
对95例患者(45例男性,平均年龄50.7±16.9岁)进行了PTS评估。其中,28.4%(95%CI 19.3 - 37.5)发生了PTS,但无严重PTS患者。PTS最常见的临床体征为静脉曲张(59%)、静脉扩张(48%)、腿部肿胀(30%)和色素沉着性皮炎(26%)。没有单一危险因素与PTS发生相关(年龄、性别、体重指数、血栓形成倾向、病因、部位、复发、症状性DVT和DVT家族史)。
PTS是一种常见疾病。然而,不同研究中诊断标准缺乏一致性,使得无法评估PTS的危险因素。