2023 年第 10 期 第 18 卷

下肢静脉血栓及炎症因子与高龄新型冠状病毒感染患者预后的关系

Relationship of lower limb venous thrombosis and inflammatory factors with novel coronavirus infection in elderly patients

作者：贺梅婷1程颐1刘凤菊1陈洁1赵青1刘东婷2

英文作者：He Meiting1 Cheng Yi1 Liu Fengju1 Chen Jie1 Zhao Qing1 Liu Dongting2

单位：1首都医科大学附属北京安贞医院综合超声科，北京100029；2首都医科大学附属北京安贞医院医学影像科，北京100029

英文单位：1Department of Comprehensive Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Medical Imaging Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：新型冠状病毒感染；下肢静脉血栓；D-二聚体

英文关键词：Novelcoronavirusinfection；Lowerlimbvenousthrombosis；D-Dimer

• 摘要：

• 目的  探讨高龄新型冠状病毒感染患者下肢静脉血栓和白细胞介素 6(IL-6)、降钙素原、D-二聚体、C反应蛋白与预后的关系。方法  选取首都医科大学附属北京安贞医院2022年12月1日至2023年1月31日收治的新型冠状病毒感染患者223例，根据患者的预后分为死亡组（80例）和存活组（143例）。比较死亡组与存活组患者静脉血栓情况、白细胞介素6（IL-6）、降钙素原、C反应蛋白水平及肺部炎症情况。并总结新型冠状病毒感染患者CT检查特征。结果  死亡组男性比例、IL-6、降钙素原、 D-二聚体及重度肺炎比例均高于存活组，差异均有统计学意义（均P＜0.001）。下肢静脉血栓患者中，死亡组IL-6、降钙素原、D-二聚体水平高于存活组患者［338(143，901)ng/L比51(20，187)ng/L、0.82(0.23，4.96)μg/L比0.10(0.07，0.70)μg/L、7 246(4 515，14 853)μg/L比2 070(1 182，4 182)μg/L］，差异均有统计学意义（均P＜0.001）。新型冠状病毒感染患者胸部CT显示病变主要位于两肺的外带区域及胸膜下，可跨越肺段的解剖分布，呈多叶浸润，CT主要表现为斑片状磨玻璃影，部分实变、纤维化。结论  高龄男性、存在下肢静脉血栓、伴有IL-6、降钙素原、D-二聚体升高的患者新型冠状病毒感染后有较高的死亡风险。

• Objective  To investigate the relationship of lower limb venous thrombosis, interleukin 6 (IL-6), procalcitonin, D-dimer, and C-reactive protein with novel coronavirus infection in elderly patients. Methods  A total of 223 patients with novel coronavirus infection admitted to Beijing Anzhen Hospital, Capital Medical University from December 1, 2022 to January 31, 2023 were selected. They were divided into death group (80 cases) and survival group (143 cases) according to the prognosis. Venous thrombosis, IL-6, procalcitonin, C-reactive protein, and severe pulmonary inflammation were compared between the death group and the survival group. CT characteristics of patients with novel coronavirus infection was summarized. Results  The proportion of male, IL-6, procalcitonin, D-dimer and the proportion of severe pneumonia in death group were higher than those in survival group (all P＜0.001). In lower limb venous thrombosis patients, levels of IL-6, procalcitonin and D-dimer in death group were higher than those in survival group ［338(143，901)ng/L vs 51(20，187)ng/L， 0.82(0.23，4.96)μg/L vs 0.10(0.07，0.70)μg/L， 7 246(4 515，14 853)μg/L vs 2 070(1 182，4 182)μg/L］(all P＜0.001). Chest CT lesions of novel coronavirus were mainly located in the peripheral area of both lungs and under the pleura, which can cross the anatomical distribution of lung segments and show multi-lobar infiltration. CT mainly showed patchy ground glass shadows, partial consolidation and fibrosis. Conclusion  After novel coronavirus infection, elderly male patients, patients with lower limb venous thrombosis, and patients with elevated IL-6, procalcitonin, and D-dimer have a higher risk of death.