中国动脉硬化杂志2026，Vol.34Issue(4)：308-316,9.DOI:10.20039/j.cnki.1007-3949.2026.04.004
基于凝血与血液流变学指标构建出血性脑卒中患者下肢深静脉血栓形成预测模型
Construction of a predictive model for lower extremity deep venous thrombosis in pa-tients with hemorrhagic stroke based on coagulation and hemorheological indicators
摘要
Abstract
Aim To explore the predictive value of hematocrit(HCT),plasma D-dimer combined with fibrinogen(FIB)for the risk of lower extremity deep venous thrombosis(DVT)in patients with hemorrhagic stroke.Methods Clinical data were retrospectively collected from 210 patients with hemorrhagic stroke admitted to the Second People's Hospital of Hefei from January 2023 to June 2025,including 81 patients with DVT(DVT group)and 129 patients without DVT(non-DVT group).120 patients with hemorrhagic stroke admitted during the same period were enrolled as the external validation cohort.Multivariate Logistic regression was employed to identify influencing factors for DVT in hemorrhagic stroke,and ROC curves together with calibration curves were applied to establish and validate the predictive model.Results Patients in the DVT group were older,with higher admission NIHSS scores,longer bedridden dura-tion,and elevated levels of HCT,FIB and D-dimer compared with the non-DVT group(P<0.05).There was no statisti-cally significant difference in other baseline data(P>0.05).Multivariate Logistic regression analysis showed that elevated NIHSS scores(OR=1.188,95%CI:1.066～1.324),prolonged bedridden duration(OR=1.569,95%CI:1.330～1.851),increased HCT(OR=1.209,95%CI:1.088～1.343),FIB(OR=2.733,95%CI:1.523～4.905)and D-dimer(OR=2.100,95%CI:1.219～3.617)at admission were independent risk factors for DVT in patients with hemorrhagic stroke(all P<0.05);the combined detection of admission NIHSS score,bedridden duration,HCT,FIB and D-dimer yielded a higher AUC for predicting DVT than any single indicator,with statistically significant differences(all P<0.05).Conclusion Elevated admission NIHSS score,prolonged bedridden duration,and increased HCT,FIB and D-dimer levels are independent risk factors for DVT in patients with hemorrhagic stroke;the combination of these indicators presents high predictive efficacy for DVT risk.关键词
出血性脑卒中/深静脉血栓形成/D-二聚体/红细胞压积/纤维蛋白原/预测模型Key words
hemorrhagic stroke/deep venous thrombosis/D-dimer/hematocrit/fibrinogen/prediction model分类
医药卫生引用本文复制引用
朱莹莹,韩肖晓,刘学春,齐胤良..基于凝血与血液流变学指标构建出血性脑卒中患者下肢深静脉血栓形成预测模型[J].中国动脉硬化杂志,2026,34(4):308-316,9.基金项目
安徽省重点研究与开发计划项目(2022e07020029) （2022e07020029）
安徽医科大学校科研基金项目(2022xkj109) （2022xkj109）
