Scott T E, LaMorte W W, Gorin D R, Menzoian J O
Department of Surgery, Boston University School of Medicine, MA, USA.
J Vasc Surg. 1995 Nov;22(5):622-8. doi: 10.1016/s0741-5214(95)70050-1.
Most epidemiologic studies on chronic venous insufficiency (CVI) are cross-sectional surveys that suggest potential risk factors by describing their population. However, these relationships could be due to the CVI population's older age. We performed a dual case-control study with multivariate analysis to address this issue.
Ninety-three patients with venous ulcers, 129 patients with varicose veins (VV), and 113 general population control patients from two hospitals were interviewed by use of a standardized questionnaire covering medical history, patient demographics, medications, and lifestyle questions. Univariate and multivariate analyses were used to compare the groups.
Univariate analyses showed CVI to be characterized by several factors, many of which were found to be age related after multivariate analysis. Age-adjusted relationships for CVI include male sex and obesity. Histories of serious leg injury or phlebitis were important associations resulting in a 2.4-fold and 25.7-fold increase in risk for CVI, respectively. After adjusting for age, subjects with VV tend to be younger and female, to more frequently have a history of phlebitis, and to report a family history of VV more frequently than control subjects.
Many of the previously suggested associations found with CVI are in reality due to this population's greater age. Patients with CVI are older, male, obese, have a history of phlebitis, and have a history of serious leg injury. These results suggest that a prior deep vein thrombosis, either clinical or subclinical, may be a predisposing factor for CVI.
大多数关于慢性静脉功能不全（CVI）的流行病学研究都是横断面调查，通过描述其研究人群来提示潜在风险因素。然而，这些关系可能是由于CVI人群年龄较大所致。我们进行了一项双病例对照研究并进行多变量分析以解决这一问题。
来自两家医院的93例静脉溃疡患者、129例静脉曲张（VV）患者和113例普通人群对照患者接受了标准化问卷调查，内容涵盖病史、患者人口统计学信息、用药情况和生活方式问题。采用单变量和多变量分析对各组进行比较。
单变量分析显示CVI具有若干特征因素，其中许多因素在多变量分析后被发现与年龄相关。CVI的年龄调整后关系包括男性和肥胖。严重腿部损伤或静脉炎病史是重要的关联因素，分别使CVI风险增加2.4倍和25.7倍。在调整年龄后，VV患者往往更年轻且为女性，静脉炎病史更常见，且比对照患者更频繁地报告有VV家族史。
先前发现的许多与CVI相关的关联实际上是由于该人群年龄较大。CVI患者年龄较大，为男性，肥胖，有静脉炎病史和严重腿部损伤史。这些结果表明，先前的临床或亚临床深静脉血栓形成可能是CVI的一个易感因素。
