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COVID-19 患者的静脉血栓栓塞症与 D-二聚体的相关性:单中心经验。

Venous thromboembolism in patients with COVID-19 and correlation with D-dimers: a single-centre experience.

机构信息

Department of Respiratory Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

Department of Respiratory Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

出版信息

BMJ Open Respir Res. 2020 Nov;7(1). doi: 10.1136/bmjresp-2020-000779.

Abstract

OBJECTIVE

To study the frequency of venous thromboembolism in hospitalised patients with COVID-19 and correlation with the D-dimers and thromboprophylaxis.

DESIGN

Cross-sectional descriptive study.

PLACE AND DURATION OF STUDY

Queen Elizabeth Hospital, 20 April 2020-13 May 2020.

PATIENTS AND METHODS

One hundred and seven (n=107) patients of PCR-confirmed COVID-19 pneumonia admitted to Queen Elizabeth Hospital, Birmingham, between 20 April 2020 and 13 May 2020 were included in the study using consecutive sampling. Data were collected using the Excel audit tool and included age, gender, weight, estimated eGFR, D-dimer values on admission, intensive care unit admission, presence of respiratory failure, imaging results for evaluation of venous thromboembolism (VTE) and anticoagulation received on admission. The data were entered in the SPSS (V.17) and were analysed. Data were summarised as means±SD, number or percentage as appropriate. A p value of less than 0.05 was considered significant.

RESULTS

The frequency of VTE was found to be 11.2% in patients hospitalised with COVID-19 pneumonia. The mean D-dimers were 3322.24 ng/mL±9603 ng/mL with the values significantly higher for patients with VTE and those requiring intensive care unit admission. All of the seven patients (100%) with D-dimers value above 2000 ng/mL who underwent imaging were found to have VTE.

CONCLUSION

VTE is frequent in patients with COVID-19 pneumonia despite anticoagulation. A higher D-dimers value correlates well with the risk of VTE in these patients and further evaluation of such patients for VTE is necessary especially with D-dimers values above 2000 ng/mL.

摘要

目的

研究 COVID-19 住院患者静脉血栓栓塞症的频率及其与 D-二聚体和血栓预防的相关性。

设计

横断面描述性研究。

地点和研究时间

伯明翰伊丽莎白女王医院,2020 年 4 月 20 日至 5 月 13 日。

患者和方法

采用连续抽样法,选取 2020 年 4 月 20 日至 5 月 13 日期间在伯明翰伊丽莎白女王医院住院的经 PCR 确诊的 COVID-19 肺炎患者 107 例。使用 Excel 审计工具收集数据,包括年龄、性别、体重、估算的 eGFR、入院时的 D-二聚体值、入住重症监护病房、呼吸衰竭的存在、用于评估静脉血栓栓塞症(VTE)的影像学结果和入院时接受的抗凝治疗。将数据输入 SPSS(V.17)进行分析。数据以均值±标准差、数量或百分比表示。p 值小于 0.05 被认为具有统计学意义。

结果

COVID-19 肺炎住院患者中 VTE 的发生率为 11.2%。平均 D-二聚体值为 3322.24ng/mL±9603ng/mL,VTE 患者和需要入住重症监护病房的患者 D-二聚体值明显更高。所有 7 例(100%)D-二聚体值>2000ng/mL 且接受影像学检查的患者均发现有 VTE。

结论

尽管进行了抗凝治疗,COVID-19 肺炎患者仍常发生 VTE。较高的 D-二聚体值与这些患者 VTE 的风险密切相关,对于此类患者,特别是 D-二聚体值>2000ng/mL 的患者,有必要进一步评估其 VTE 风险。

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