Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi Area, Zhengzhou, 450000, Henan Province, People's Republic of China.
Mol Neurobiol. 2016 Oct;53(8):5671-8. doi: 10.1007/s12035-015-9487-5. Epub 2015 Oct 21.
Deep venous thrombosis (DVT) is a complication of stroke. Our aim was to determine whether D-dimer plasma levels at admission could be a risk factor for DVT in Chinese patients with acute intracerebral hemorrhage (ICH). From December 2012 to November 2014, all patients with first-ever acute ICH were included. At baseline, the demographical and clinical data were taken. These patients were assessed for DVT using color Doppler ultrasonography (CDUS) on 15 days after ICH and whenever clinically requested. Multivariate analyses were performed using logistic regression models. Receiver operating characteristic (ROC) curves were used to test the overall predictive accuracy of D-dimer and other markers. In our study, acute ICH was diagnosed in 265 patients and 210 completed a 15-day follow-up and were included in the analysis. Fifty-four (25.7 %) out of the 210 patients were diagnosed as DVT. Plasma D-dimer levels were significantly higher in ICH patients with DVT as compared to those without DVT (P < 0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that plasma D-dimer levels ≥1.20 mg/L were an independent predictor of DVT [odds ratio (OR) = 12.99, 95 % confidence interval (CI) = 3.17-32.98; P < 0.0001]. With an area under the curve (AUC) of 0.91 (95 % CI = 0.86-0.94), D-dimer showed a significantly greater discriminatory ability to predict DVT as compared with high-sensitivity C-reactive protein (Hs-CRP) (AUC = 0.77, 95 % CI = 0.70-0.82; P < 0.01), homocysteine (HCY) (AUC = 0.75, 95 % CI = 0.70-0.81; P < 0.01), and National Institutes of Health Stroke Scale (NIHSS) score (AUC = 0.80, 95 % CI = 0.72-0.85; P < 0.01). The present study suggested that elevated D-dimer plasma levels were independent predictors for DVT in Chinese patients with ICH.
深静脉血栓形成(DVT)是中风的一种并发症。我们的目的是确定入院时 D-二聚体血浆水平是否可作为中国急性脑出血(ICH)患者发生 DVT 的危险因素。2012 年 12 月至 2014 年 11 月,所有首次发生急性 ICH 的患者均被纳入研究。基线时,采集患者人口统计学和临床数据。ICH 后 15 天和临床需要时,使用彩色多普勒超声(CDUS)对这些患者进行 DVT 评估。采用逻辑回归模型进行多变量分析。受试者工作特征(ROC)曲线用于测试 D-二聚体和其他标志物的总体预测准确性。在本研究中,诊断 265 例急性 ICH,210 例完成 15 天随访并纳入分析。210 例患者中,54 例(25.7%)被诊断为 DVT。与无 DVT 的 ICH 患者相比,DVT 患者的血浆 D-二聚体水平显著升高(P<0.0001)。经常见危险因素调整的多变量逻辑回归分析显示,血浆 D-二聚体水平≥1.20mg/L 是 DVT 的独立预测因子[比值比(OR)=12.99,95%置信区间(CI)=3.17-32.98;P<0.0001]。D-二聚体的曲线下面积(AUC)为 0.91(95%CI=0.86-0.94),与高敏 C 反应蛋白(Hs-CRP)(AUC=0.77,95%CI=0.70-0.82;P<0.01)、同型半胱氨酸(HCY)(AUC=0.75,95%CI=0.70-0.81;P<0.01)和美国国立卫生研究院卒中量表(NIHSS)评分(AUC=0.80,95%CI=0.72-0.85;P<0.01)相比,D-二聚体对预测 DVT 具有显著更高的鉴别能力。本研究表明,入院时血浆 D-二聚体水平升高是中国 ICH 患者发生 DVT 的独立预测因子。