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妊娠和产后深静脉血栓形成的负担及危险因素——反映我们地区的特殊性

The Burden of Deep Vein Thrombosis and Risk Factors in Pregnancy and Postpartum-Mirroring Our Region's Particularities.

作者信息

Filip Catalina, Socolov Sofia Alexandra, Matasariu Daniela Roxana, Ursache Alexandra, Pisla Karina Delia, Gisca Tudor Catalin, Mihalceanu Elena, Boiculese Vasile Lucian, Socolov Demetra

机构信息

Department of Vascular Surgery, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iasi, Romania.

CHU "Gabriel Montpied", 63000 Clermont-Ferrand, France.

出版信息

J Clin Med. 2024 Aug 11;13(16):4705. doi: 10.3390/jcm13164705.

Abstract

(1) The three factors within the Virchow triad play the leading role in the development of deep vein thrombosis (DVT) during pregnancy. (2) This research approaches the various risk factors associated with DVT and its most representative complications, pulmonary thromboembolism and cerebral venous thrombosis, in pregnant and postpartum women across a 15-year period (2007-2021). (3) A total of 201 out of 287 patients with DVT had associated risk factors, while 86 did not present with any. Out of the 201 patients with risk factors, 47 developed pulmonary thromboembolism, while 12 experienced cerebral thrombosis. The statistical analysis of risk factors involved in DVT revealed high significance for obesity (OR 3.676; CI 2.484-5.439), gestational diabetes (OR 3.394; CI 2.101-5.483), hypertension (OR 2.325; CI 1.591-3.397), preeclampsia (OR 4.753; CI 2.342-9.645), thrombophilia (OR 12.138; CI 8.973-16.417), and varicose veins (OR 9.678; CI 7.321-12.793); for pulmonary thromboembolism, there was high significance for obesity (OR 7.867; CI 4.297-14.401), hypertension (OR 2.605; CI 1.246-5.446), preeclampsia (OR 7.483; CI 2.346-23.872), thrombophilia (OR 11.035; CI 5.910-20.602), and varicose veins (OR 6.837; CI 3.665-12.757); and for cerebral thromboembolism (CTE), the risk factors identified were obesity (OR 6.755; CI 1.954-23.347), hypertension (OR 1.167; CI 0.155-8.770), preeclampsia (OR 9.655; CI 1.283-72.672), and thrombophilia (OR 33.275; CI 12.884-85.939). (4) Obesity was the only significant factor found to influence DVT, pulmonary embolism and CTE risks, and hereditary thrombophilia was the main factor influencing the risk for pulmonary thromboembolism and CTE. Systemic lupus erythematosus and gestational diabetes revealed conflicting results that require further investigation.

摘要

(1) 魏尔啸三联征中的三个因素在孕期深静脉血栓形成(DVT)的发展过程中起主导作用。(2) 本研究探讨了15年期间(2007 - 2021年)妊娠和产后妇女中与DVT及其最具代表性的并发症肺血栓栓塞症和脑静脉血栓形成相关的各种危险因素。(3) 287例DVT患者中,共有201例存在相关危险因素,86例未出现任何危险因素。在201例有危险因素的患者中,47例发生了肺血栓栓塞症,12例发生了脑血栓形成。对DVT相关危险因素的统计分析显示,肥胖(OR 3.676;CI 2.484 - 5.439)、妊娠期糖尿病(OR 3.394;CI 2.101 - 5.483)、高血压(OR 2.325;CI 1.591 - 3.397)、子痫前期(OR 4.753;CI 2.342 - 9.645)、易栓症(OR 12.138;CI 8.973 - 16.417)和静脉曲张(OR 9.678;CI 7.321 - 12.793)具有高度显著性;对于肺血栓栓塞症,肥胖(OR 7.867;CI 4.297 - 14.401)、高血压(OR 2.605;CI 1.246 - 5.446)、子痫前期(OR 7.483;CI 2.346 - 23.872)、易栓症(OR 11.035;CI 5.910 - 20.602)和静脉曲张(OR 6.837;CI 3.665 - 12.757)具有高度显著性;对于脑栓塞(CTE),确定的危险因素为肥胖(OR 6.755;CI 1.954 - 23.347)、高血压(OR 1.167;CI 0.155 - 8.770)、子痫前期(OR 9.655;CI 1.283 - 72.672)和易栓症(OR 33.275;CI 12.884 - 85.939)。(4) 肥胖是唯一被发现影响DVT、肺栓塞和CTE风险的显著因素,遗传性易栓症是影响肺血栓栓塞症和CTE风险的主要因素。系统性红斑狼疮和妊娠期糖尿病显示出相互矛盾的结果,需要进一步研究。

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