The Department of Vascular and Interventional Radiology, 385685Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221131034. doi: 10.1177/10760296221131034.
This study aimed to evaluate risk factors for silent pulmonary embolism (PE) in symptomatic deep vein thrombosis (DVT) and investigate the relationship between DVT and silent PE.
This was a single-centre, retrospective cohort study. Between 5 January 2015 and 31 December 2021, consecutive patients with symptomatic DVT received CT pulmonary angiography and CT venography were analyzed. Patient demographics, comorbidities, risk factors, and image findings were analyzed. The group differences were compared using a Chi-square test, Fisher's exact test, independent t test, or Mann-Whitney U test. Multivariant regression was used to determine predictive factors for silent PE.
A total of 355 patients (mean age, 60.5 ± 16.6 years) were included. The incidence of silent PE was 43.1%. The main or lobar pulmonary arteries were affected in 53.6% of patients, which is more often found in iliofemoral DVTs (56.6% vs 26.7%, = .027). The multivariant analysis showed male patients ( = .042; OR 1.59; 95% CI, 1.02-2.50), inferior vena cava involvement ( = .043; OR 1.81; 95% CI, 1.02-3.20) and D-dimer value>3.82 μg/ml (<.001; OR 2.32; 95% CI, 1.43-3.77) were risk factors for silent PE. Unilateral DVT patients with ipsilateral iliac vein compression had a lower incidence of silent PE (28.8% vs 52.9%, .001).
Iliofemoral DVT was associated with a more proximal PE. The male patients, inferior vena cava involvement, and D-dimer>3.82 μg/ml were risk factors for silent PE. Ipsilateral iliac vein compression reduced the incidence of silent PE.
本研究旨在评估有症状深静脉血栓形成（DVT）患者发生无症状肺栓塞（PE）的危险因素，并探讨 DVT 与无症状 PE 之间的关系。
这是一项单中心、回顾性队列研究。2015 年 1 月 5 日至 2021 年 12 月 31 日期间，连续对因有症状 DVT 而行 CT 肺动脉造影和 CT 静脉造影的患者进行分析。分析患者的人口统计学、合并症、危险因素和影像学表现。使用卡方检验、Fisher 确切检验、独立 t 检验或 Mann-Whitney U 检验比较组间差异。采用多变量回归分析确定无症状 PE 的预测因素。
共纳入 355 例患者（平均年龄 60.5±16.6 岁）。无症状 PE 的发生率为 43.1%。53.6%的患者主要或叶肺动脉受累，在髂股静脉 DVT 中更常见（56.6%比 26.7%，=0.027）。多变量分析显示男性患者（=0.042；OR 1.59；95%CI，1.02-2.50）、下腔静脉受累（=0.043；OR 1.81；95%CI，1.02-3.20）和 D-二聚体值>3.82μg/ml（<0.001；OR 2.32；95%CI，1.43-3.77）是无症状 PE 的危险因素。对侧髂静脉受压的单侧 DVT 患者无症状 PE 的发生率较低（28.8%比 52.9%，=0.001）。
髂股静脉 DVT 与更近端的 PE 相关。男性患者、下腔静脉受累和 D-二聚体>3.82μg/ml 是无症状 PE 的危险因素。同侧髂静脉受压可降低无症状 PE 的发生率。
