2020 年第 7 期 第 15 卷

Padua预测评分表评估新型冠状病毒肺炎患者下肢深静脉血栓形成风险的有效性

Validity of Padua forecast score table in assessment the risk of deep venous thrombosis of patients with corona virus disease-19

作者：高伟1高杨1孙麓2刘双1

英文作者：Gao Wei1 Gao Yang1 Sun Lu2 Liu Shuang1

单位：1首都医科大学附属北京安贞医院呼吸与危重症医学科100029；2华中科技大学同济医学院附属协和医院西院综合科，武汉430000

英文单位：1Department of Respiratory and Critical Care Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Comprehensive West Hospital of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology Wuhan 430000 China

关键词：新型冠状病毒肺炎；下肢深静脉血栓形成；Padua预测评分表

英文关键词：Coronavirusdisease-19;Deepvenousthrombosis;Paduaforecastscoretable 

• 摘要：

• 目的  探讨Padua预测评分表评估新型冠状病毒肺炎（COVID-19）患者下肢深静脉血栓形成（DVT）风险的有效性。方法入选2020年2月11日至3月22日华中科技大学同济医学院附属协和医院西院确诊COVID-19的212例患者，住院时间>1周，D二聚体升高≥正常值上限2倍。用Padua预测评分表评估，对46例评分≥4分的DVT高危患者进行床旁下肢血管超声检查，分析DVT各部位发生率，根据是否发生DVT分为DVT组（22例）和非DVT组（24例）。分析2组Padua分值差异，Padua评分与血栓危险分级的关系及其对COVID-19患者DVT的诊断价值。结果212例初步入选患者中，有46例（21.7%）患者Padua评分≥4分，其中22例（47.8%）超声诊断合并DVT，共54处，以腓肠肌静脉和胫后静脉为主，分别占59.3%（32/54）和22.2%（12/54）。CMH检验结果显示，Padua评分分值与DVT发生风险显著相关，组间差异有统计学意义（χ2=19.00，P<0.01）。Padua评分≥6分预测COVID-19患者发生DVT的受试者工作特征曲线下面积为0.938，敏感度为63.6%，特异度为95.8%，诊断约登指数为0.595。结论对COVID-19患者，Padua预测评分表可以有效进行血栓危险分级。Padua评分≥6分对诊断COVID-19患者DVT有较高的特异性。

• ObjectiveTo investigate the validity of Padua forecast score table in assessment the risk of deep venous thrombosis(DVT) of patients with corona virus disease-19(COVID-19). Methods From February 11 to March 22 ，2020totally 212 patients diagnosed with COVID-19 admitted to West Hospital of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were selected. All patients stayed in hospital for more than 1 week, and D-dimer increased by more than or equal to 2 times the upper limit of normal.Forty-six patients with high risk of DVT with Padua prediction score ≥4 were examined by bedside vascular ultrasound T he incidence of various parts of DVT was analyzed. Forty-six patients were divided into DVT group (22 cases) and non-DVT group (24 cases).The difference of Padua score ,the relationship between Padua score and thrombus risk classification, as well as the diagnostic value of Padua score for DVT in COVID-19 patients were analyzed.Results  Among 212 primary patients, there were 46 patients(21.7%) with Padua predictive score ≥ 4 and 22cases(47.8%) were diagnosed with DVT by ultrasound in total 54 sites. Thrombosis were mainly in gastrocnemius vein and the posterior tibial vein accounting to 59.3%（32/54） and 22.2%（12/54）, respectively. The results of CMH test showed that Padua score was significantly related to the risk of DVT（χ2=19.00, P<0.01）. The area under the receiver operator characteristic curve predicting DVT occurrence in COVID-19 patients by Padua predictive score≥6 was 0.938, the diagnostic Youden′s index was 0.595, with 63.6% sensitivity and 95.8% specificity. Conclusions  For COVID-19 patients, the Padua forecast score table would be effective for thromboembolism risk classification. Padua score ≥ 6 is highly specific for the diagnosis of DVT in COVID-19 patients.