Yetkin Ertan, Ileri Mehmet, Waltenberger Johannes
Yenisehir Hospital Division of Cardiology Mersin, Turkey.
Department of Cardiology, Numune Training and Research Hospital, Ankara, Turkey.
Clin Hemorheol Microcirc. 2018;68(4):413-419. doi: 10.3233/CH-170320.
In the absence of trauma, hematologic disease and anti-platelet use, no attention has been paid to elucidate the mechanism of ecchymosis. It has taken our attention that ecchymosis on lower limb might be a sign of varicose vein. Accordingly, we aimed to analyze and describe the frequency of leg symptoms and presence of ecchymosis in patients with varicose vein.
Four hundred and ninety four patients who had been diagnosed as having varicose vein or chronic venous insufficiency either by clinical examination or Doppler ultrasonography were included in the study. Leg symptoms were defined as pain, itching, muscle cramps, throbbing, and swelling. Ulcers, pigmentations and ecchymosis were recorded as signs of varicose vein. Ecchymosis was defined as a hemorrhagic lesions, larger than >3 mm on the skin of lower extremities, forming a flat, rounded or irregular, blue or purplish patch.
Leg pain was the most common symptom in our study population. Ecchymosis was observed in 24 patients (5%). Logistic regression analysis showed that ecchymosis was significantly and positively associated with muscle cramps (Odds ratio: 5.82, p = 0.001) and female gender (Odds ratio: 5.17 p = 0,019 but negatively associated with age (Odds ratio: 0.94, p = 0.004).
We have documented for the first time that the frequency of ecchymosis and its association with muscle cramps in a relatively large patient population with peripheral varicose vein or chronic venous insufficiency. Ecchymosis on lower limbs should be considered as a novel sign of varicose vein.
在无创伤、血液系统疾病及未使用抗血小板药物的情况下，人们尚未关注瘀斑形成的机制。我们注意到下肢瘀斑可能是静脉曲张的一个迹象。因此，我们旨在分析和描述静脉曲张患者腿部症状的发生频率及瘀斑的出现情况。
本研究纳入了494例经临床检查或多普勒超声诊断为静脉曲张或慢性静脉功能不全的患者。腿部症状定义为疼痛、瘙痒、肌肉痉挛、搏动和肿胀。溃疡、色素沉着和瘀斑被记录为静脉曲张的体征。瘀斑定义为下肢皮肤上大于3毫米的出血性病变，形成扁平、圆形或不规则的蓝色或紫色斑块。
腿部疼痛是我们研究人群中最常见的症状。24例患者（5%）出现瘀斑。逻辑回归分析显示，瘀斑与肌肉痉挛显著正相关（比值比：5.82，p = 0.001）以及与女性性别显著正相关（比值比：5.17，p = 0.019），但与年龄呈负相关（比值比：0.94，p = 0.004）。
我们首次记录了在相对较大的外周静脉曲张或慢性静脉功能不全患者群体中瘀斑的发生频率及其与肌肉痉挛的关联。下肢瘀斑应被视为静脉曲张的一个新体征。
