Prospective 12-year follow-up study of clinical and hemodynamic sequelae after deep vein thrombosis in low-risk patients (Zürich study).
Prospective 12-year follow-up study of clinical and hemodynamic sequelae after deep vein thrombosis in low-risk patients (Zürich study).
复制标题
低风险患者深静脉血栓形成后临床和血流动力学后遗症的前瞻性 12 年随访研究（苏黎世研究）。
作者：
U. Franzeck;I. Schalch;K. Jäger;E. Schneider;J. Grimm;Alfred Bollinger
背景
到目前为止，还没有关于急性深静脉血栓形成后10年以上长期后遗症的前瞻性研究。因此，58例低风险DVT患者被纳入一项前瞻性研究，以评估血栓后综合征的自然史。
方法和结果
在入院时、3个月、6个月和12个月后、第2年、第3年、第4年、第5年后以及最后第12年后进行临床和血流动力学检查。所有患者最初均接受肝素治疗，随后口服抗凝剂。12年后，64%的患者表现出正常的结果。28%的患者出现轻度皮肤变化，5%的患者出现明显的营养变化，仅发生1例静脉性溃疡。54%的多节段血栓形成患者报告定期使用加压袜。虽然平均最大静脉流出量从急性事件到12年后与对侧腿相比显著降低（P<.003），但6个月后观察到显著改善（P<.05）。3个月后通过多普勒超声检测小腿静脉血栓再通。64%的多节段血栓在1年后完全或部分再通; 69%的患者发现瓣膜功能不全。
结论
与早期报告相反，这项前瞻性研究显示，深静脉血栓形成后长达12年，口服抗凝剂和定期压迫治疗的血栓后综合征发生率较低。然而，不良临床事件发生率（死亡率14%）和24%的复发率表明，即使在低风险患者中，深静脉血栓形成后的预后也不理想。
BACKGROUND
No prospective study of the long-term sequelae of more than 10 years after acute deep vein thrombosis exists so far. Therefore, 58 low-risk patients with DVT were included in a prospective study to evaluate the natural history of postthrombotic syndrome.
METHODS AND RESULTS
Clinical and hemodynamic examinations were performed at the time of admission; after 3, 6, and 12 months; after the 2nd, 3rd, 4th, 5th years; and finally after the 12th year. All patients received heparin initially and oral anticoagulants subsequently. After 12 years, 64% of the patients exhibited normal findings. Mild skin changes were found in 28%, marked trophic changes in 5%, and only one venous ulcer occurred. Regular use of compression stockings was reported by 54% of the patients with multilevel thrombosis. Although mean maximum venous outflow was significantly reduced from the acute event to 12 years later (P<.003) compared with the contralateral leg, a significant (P<.05) improvement was observed 6 months later. Recanalization of calf vein thrombosis was detected by Doppler sonography after 3 months. Sixty-four percent of the multilevel thromboses were recanalized completely or in part after 1 year; in 69%, valvular incompetence was found.
CONCLUSIONS
In contrast to earlier reports, this prospective study up to 12 years after deep vein thrombosis demonstrates a low incidence of postthrombotic syndrome by administration of oral anticoagulants and regular compression therapy. However, the adverse clinical event rate (mortality 14%) and a recurrence rate of 24% show that the prognosis after deep vein thrombosis does not appear favorable even in low-risk patients.
深静脉血栓的自发溶解：发生率和结果。
影响因子：
4.3
作者：
Killewich,LA;Bedford,GR;Beach,KW;StrandnessJr,DE
通讯作者：
StrandnessJr,DE