作　　者： ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;

机构地区： 浙江大学医学院附属邵逸夫医院

出　　处： 《中华炎性肠病杂志（中英文）》 2017年第1期24-28,共5页

摘　　要： 目的 回顾性调查中国炎症性肠病(inflammatory bowel disease, IBD)患者的血栓发生率、血栓筛查及预防性抗血栓现状.方法 回顾性纳入全国16个医院自2011年1月1日至2016年6月30日就诊并确诊IBD的患者,收集分析患者人口学特征、血栓筛查、预防以及血栓事件信息.结果 研究共纳入7 976名IBD患者,15.99%患者接受血栓筛查,主要为D-二聚体和彩色多普勒超声,1.98%患者接受预防性抗血栓治疗.在34名患者中共发生48例血栓事件,血栓事件发生率为41.45/10 000人·年,54.17%为下肢深静脉血栓,12.5%为肺栓塞,有1例患者死于肺栓塞.结论 中国基于医院IBD患者的血栓发生率与国外基于IBD人群的调查结果相似,但中国血栓筛查及预防性抗血栓治疗普遍不足. Objective The aim of the current study was to investigate the incidence of VTE in Chinese IBD patients.Methods History of all IBD patients in 16 tertiary referral hospitals from January,2011 to June,2016 were retrospectively retrieved.IBD diagnostic information,screening for VTE,thromboprophylaxis,and VTE events were reviewed.IR and characteristics of VTE were analyzed.Results 7 976 IBD patients were followed up for 11 579.6 person-years.The median time of follow up was 9.3 months(interquartile range:0.5?29).15.99%of the patients underwent VTE screening,which primarily consists of d-dimer assessment and deep vein ultrasound.1.98%of the patients received thromboprophylaxis.However,only 28 patients received proper pn)phylaxis,which included warfarin,heparin or low molecular weight heparin.None of these patients developed VTE.A total of 48 VTE events diagnosed in 34 patients were identified.The IR of VTE in Chinese IBD patients was 41.45/10,000 person-years.29.4%of the patients developed VTE in multiple veins.DVT and PE accounted for 54.17%,12.5%of all VTE events,respectively.Apart from DVT and PE,thrombosis of the portal vein systems accounted for 14.6%of VTE events,which was comparable to that of PE.One patient died due to PE.Conclusions Incidence of VTE among IBD patients from major hospitals in China is not lower than reports from other population-based studies.Thrombosis screening and thromboprophylaxis are not widely practiced.While DVT is the mostly common VTE,thrombosis of the portal vein system and PE are equally likely to develop in IBD patients.Physicians need to recognize the importance of screening and thromboprophylaxis in IBD patients.

关 键 词： 炎症性肠病 深静脉血栓 肺栓塞血栓 预防

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