Czihal M, Paul S, Rademacher A, Bernau C, Hoffmann U
Division of Vascular Medicine, Medical Clinic and Policlinic IV, Munich University Hospital, Germany
Division of Vascular Medicine, Medical Clinic and Policlinic IV, Munich University Hospital, Germany.
Phlebology. 2015 Mar;30(2):105-12. doi: 10.1177/0268355513517226. Epub 2013 Dec 10.
To explore the association of the postthrombotic syndrome with venous hemodynamics and morphological abnormalities after upper extremity deep venous thrombosis.
Thirty-seven patients with a history of upper extremity deep venous thrombosis treated with anticoagulation alone underwent a single study visit (mean time after diagnosis: 44.4 ± 28.1 months). Presence and severity postthrombotic syndrome were classified according to the modified Villalta score. Venous volume and venous emptying were determined by strain-gauge plethysmography. The arm veins were assessed for postthrombotic abnormalities by ultrasonography. The relationship between postthrombotic syndrome and hemodynamic and morphological sequelae was evaluated using univariate significance tests and Spearman's correlation analysis.
Fifteen of 37 patients (40.5%) developed postthrombotic syndrome. Venous volume and venous emptying of the arm affected by upper extremity deep venous thrombosis did not correlate with the Villalta score (rho = 0.17 and 0.19; p = 0.31 and 0.25, respectively). Residual morphological abnormalities, as assessed by ultrasonography, did not differ significantly between patients with and without postthrombotic syndrome (77.3% vs. 86.7%, p = 0.68).
Postthrombotic syndrome after upper extremity deep venous thrombosis is not associated with venous hemodynamics or residual morphological abnormalities.
探讨上肢深静脉血栓形成后血栓后综合征与静脉血流动力学及形态学异常之间的关联。
37例仅接受抗凝治疗的上肢深静脉血栓形成病史患者接受了单次研究访视（诊断后平均时间：44.4±28.1个月）。根据改良Villalta评分对血栓后综合征的存在情况及严重程度进行分类。通过应变片容积描记法测定静脉容量和静脉排空情况。通过超声检查评估上肢静脉的血栓后异常情况。使用单因素显著性检验和Spearman相关性分析评估血栓后综合征与血流动力学及形态学后遗症之间的关系。
37例患者中有15例（40.5%）发生血栓后综合征。上肢深静脉血栓形成所累及上肢的静脉容量和静脉排空情况与Villalta评分无相关性（rho分别为0.17和0.19；p分别为0.31和0.25）。经超声检查评估，有和无血栓后综合征患者之间的残余形态学异常无显著差异（77.3%对86.7%；p = 0.68）。
上肢深静脉血栓形成后的血栓后综合征与静脉血流动力学或残余形态学异常无关。
