Department of ultrasound, The Fourth Centre Hospital of Tianjin, Tianjin, China.
Department of Radiology, The Fifth Centre Hospital of Tianjin, Tianjin, China.
J Ultrasound Med. 2023 Sep;42(9):2073-2082. doi: 10.1002/jum.16227. Epub 2023 Apr 3.
To evaluate the risk factors of isolated distal deep vein thrombosis (IDDVT) in the lower limbs by using a combination of Doppler ultrasound and thrombus molecular markers.
A prospective cohort study was used. We selected 145 patients with deep vein thrombosis of the lower limbs. They were divided into the IDDVT group and the non-IDDVT group. We compared the differences in Doppler ultrasound and biochemical indexes between the two groups. The independent influencing factors of IDDVT were analyzed using logistic regression, and we plotted the receiver operating characteristic (ROC) curve.
We compared 47 IDDVT cases diagnosed by DSA with 47 non-IDDVT cases selected at random. The diameter of the common femoral vein (CFV) of the affected side, deep femoral vein, and the great saphenous vein, thickness of subcutaneous tissue, and serum D-dimer (D-D) and thrombin-antithrombin III complexes (TAT) were significantly higher in the IDDVT group than the non-IDDVT group (P < .05). Logistic regression analysis showed that CFV diameter, subcutaneous tissue thickening, D-D, and TAT were all independent risk factors for IDDVT (P < .05). The combined predictor had higher predictive sensitivity, specificity, and Youden's index (93.6, 87.2, and 0.808, respectively) than using thrombus molecular markers alone or Doppler ultrasound alone.
D-D and TAT, the thrombosis molecular markers, CFV diameter, and thickening of subcutaneous tissue, as well as the Doppler ultrasound, all have their own independent effects on IDDVT. When Thrombosis molecular markers and Doppler ultrasound are used in combination, they can predict which patients are at high risk of IDDVT and help doctors in making clinical decisions pertaining to prevention and treatment.
运用多普勒超声联合血栓分子标志物评估下肢单纯远端深静脉血栓（IDDVT）的危险因素。
采用前瞻性队列研究。选择下肢深静脉血栓患者 145 例，分为 IDDVT 组和非 IDDVT 组，比较两组多普勒超声和生化指标的差异，采用 logistic 回归分析 IDDVT 的独立影响因素，并绘制受试者工作特征（ROC）曲线。
DSA 诊断的 47 例 IDDVT 患者与随机选择的 47 例非 IDDVT 患者进行比较，患侧股总静脉（CFV）、股深静脉、大隐静脉直径，皮下组织厚度，血清 D-二聚体（D-D）和凝血酶-抗凝血酶 III 复合物（TAT）均高于非 IDDVT 组（P<.05）。logistic 回归分析显示，CFV 直径、皮下组织增厚、D-D、TAT 均为 IDDVT 的独立危险因素（P<.05）。联合预测因子的预测敏感性、特异性和 Youden 指数（分别为 93.6%、87.2%和 0.808）均高于单独使用血栓分子标志物或多普勒超声。
血栓分子标志物 D-D、TAT、CFV 直径、皮下组织增厚及多普勒超声对 IDDVT 均有独立作用，血栓分子标志物和多普勒超声联合应用可预测 IDDVT 高危患者，有助于临床医生进行防治决策。
