Analysis Of Primary And Secondary Risk Factors For Venous Thromboembolism

ObjectiveTo analyze the clinical data of 317 cases of venous thromboembolism(VTE) patients,and to detect protein C(PC), protein S(PS), antithrombinⅢ(ATⅢ) activity levels of partial VTE patients, to analyze the age,sex,clinical characteristics of VTE patients, and to explore the relationship between venous thromboembolism and primary and secondary risk factors, to provide the theoretical basis for early prevention of venous thromboembolism. MethodsFrom January 2014 to January 2015, the clinical data of patients with VTE who were treated in Vascular Surgery of the Fifth Affiliated Hospital of Zhengzhou University were collected. The information of age, sex, smoking history, medical history, surgical trauma history, basic disease, lipid levels of patients were filled in self-made case report form. 124 patients who were treated without anticoagulant therapy for 2 weeks were regarded as observation group, while 65 healthy persons were regarded as control group. The activtities of PC, PS and ATⅢ of these two groups were measured, SPSS17.0 was used to analyze the relationship between VTE and anticoagulant deficiency,and to analyze the age, sex, clinical characteristics and secondary risk factor of venous thromboembolism patients. Results1. 317 patients with VTE were enrolled, aged from 18 to 87 years old, the mean age was(59.4±13.9) years old, and the ratio between male and female was 1.17. 270 patients with the ratio between man and female 1.14 were at their first diagnosis, and the peak ages were between 40 and 80 years. There was no significant difference in the age distribution of composition in male and female( c2=3.055,P=0.88).2. Compared with the control group, the activities of PC, PS, ATⅢ of the ob servation group decreased obviously, there was significant difference between two groups(P<0.05). PS deficiency(22.6%) was the most followed by PC deficiency(13.7%) and ATⅢ deficiency(10.5%) in the observation group, The deficiency of these three anticoagulants was 38.7%. There was only 1 case of PS deficiency in control group, There was significant difference in anticoagulant deficiency between observation group and control group( c2=22.31,P<0.05). There were 48 cases of anticoagulant deficiency patients and 76 cases of anticoagulant normal patients in 124 cases of patients. The age of anticoagulant deficiency group was less than anticoagulant normal group(t=-2.931,P<0.05). There were 21 cases of recurrent patients and 103 incipient patients in 124 cases of patients. There were 13 cases(61.9%) of anticoagulant proteins deficiency in recurrent patients and 35 cases(34.0%) of anticoagulant proteins deficiency in incipient patients. There was significant difference in anticoagulant proteins between recurrent group and incipient group( c2=5.733,P<0.05).3. Trauma and(or) surgery and malignant tumors were the top two risk factors in the current recognized secondary risk factors. Hypertension and cigarette smoking were the top two risk factors in possible risk factors, and 67.5% of the patients had more than 2 secondary risk factors. Bone surgery(24.1%) was the first factors in Trauma and(or) surgery risk factors, followed by gastrointestinal surgery(16.7%). The highest percentage of patients with malignant tumor and VTE were the digestive tract tumor patients, followed by gynecological tumor >lung cancer>urologic tumor>breast cancer patients. The highest percentage of TNM staging in patients with malignant tumor and VTE was Ⅳ period, followed by Ⅲperiod>Ⅱperiod>Ⅰperiod. Conclusions1. The peak ages of the first diagnosis VTE patients were between 40 to 80 years old.2. The deficiencies of PS, PC, ATⅢ are important primary risk factors in triggering VTE. The major primary risk factors were PS deficiency and PC deficiency. The deficiency of anticoagulant proteins may be important risk factor of recurrent thrombosisi.3. The major secondary risk factors were Trauma and(or) surgery and malignant tumors. TNM staging of tumor may have a certain correlation with the incidence of VTE.4. The coexistence of multiple risk factors is an important cause in triggering VTE.