老年内科患者血栓前状态的调查及诊断标准的探讨

目的探讨老年内科血栓前状态的诊断标准。方法测定入选者vWF、Fbg、PC、AT、D-D等5项凝血指标，以指标异常数日为分组标准，统计分析各类静脉血栓高危疾病在各组的差异。结果vWF、Fbg、PC、AT、D-D等5项指标中，无异常组与至少1项异常组比较，只有感染患者在后组中发病率显著增加（P=0．03）；而2项以下指标异常组与至少2项指标异常组比较，感染、肿瘤、心脑血管疾病的患病率在后组中显著增高（P〈0．001，P=0．008，P=0．039），而其它组显著降低（P〈0．001）。通过危险因素分析，vwF、DD、Fbg和AT为较敏感指标。结论PC、AT、vwF、Fbg、D-D等5项指标中至少2异常，对VTE相关血栓前状态有一定诊断价值。其中D-D、Fbg、vWF、AT为更可靠的指标。

Investigation and Diagnosis of Prethrombotic State in Aging Internal Patients

Objectives To discuss the diagnostic criteria of prethrombotic state in aging internal patients. Methods We examined PC,AT,Fbg,vWF, D-D for aged intern patients, and divided groups according to numbers of abnormal coagulant markers. Analyze the statistical differences of incidences of high risk diseases for VTE between different groups. Results For PC, AT, vWF, Fbg, D-D, only incidence of infection was higher in ＂at least one marker abnormal group＂ than in ＂ all markers normal group＂ （P=0.03）. But the incidences of infection, heart and cerebral vascular disease, and cancer were higher in ＂ at least two markers abnormal group＂ than in ＂less than two markers abnormal group＂ （P 〈0. 001, P =0. 008,P =0. 039） , and the incidence of other diseases were lower （P 〈0. 001 ）. After analyzing the risk factors, we found that AT, vWF, Fbg, D-D were better markers to detect prethrombotic state. Conclusion At least 2 of the markers below abnormal may diagnosis the prethrombotic state in aging patients with high risk of VTE： PC, AT, vWF, Fbg, D-D. Between them, D-D, Fbg, vWF, AT were more reliable.