ObjectiveTo explore the causal association between venous thromboembolism (VTE) and cardiovascular disease (CVD) risks using a two-sample bidirectional Mendelian randomization (MR) study. MethodsThe single-nucleotide polymorphism (SNP) data associated with VTE and CVD from genome-wide association studies were obtained as instrumental variables. Inverse variance weighted (IVW) was used as the main MR method and other methods were used as supplementary methods. Cochran's Q test, the intercept term of MR-Egger, and MR-PRESSO were used to assess pleiotropy and heterogeneity to ensure the robustness of the results. ResultsThe IVW method suggested a causal association between VTE and atrial fibrillation (OR=1.033, 95%CI 1.009 to 1.058, P=0.008), but no association was identified between VTE and coronary artery disease (OR=0.994, 95%CI 0.974 to 1.023, P = 0.551), heart failure (OR=1.021, 95%CI 0.992 to 1.050, P=0.159) and myocardial infarction (OR=1.012, 95%CI 0.971 to 1.055, P=0.568). The results of Cochran's Q test showed that there was no heterogeneity in the MR analyses of VTE and CVD. The MR-Egger intercept analysis and the MR-PRESSO global testing did not detect potential horizontal pleiotropy, and the results were robust. Reverse MR analysis was used to verify the presence of reverse causal associations. The reverse MR analysis demonstrated that reverse causal associations between VTE and CVD were not evidenced. ConclusionThe results of the MR study demonstrated a causal association between VTE and atrial fibrillation, but not with coronary artery disease, heart failure or myocardial infarction.
ObjectiveTo investigate the hotspots and frontiers and to reveal research trends of cirrhosis with portal vein thrombosis (PVT) by visual analysis.MethodsWe explored the distributions, key citations and research trends of articles on cirrhosis with PVT published from 1991 to 2020 by citation analysis, co-word analysis, and burst detection by information visual software CiteSpace.ResultsThe quantity of articles on cirrhosis with PVT had been increasing over time. The management of PVT remained the hotspots, while the efficacy and prognosis of anticoagulation of PVT as well as the risk factors and underlying mechanisms of PVT had been frontiers in recent years.ConclusionsAnticoagulation and risk factors have been hotspots and frontiers in recent years.
【Abstract】ObjectiveTo detect the levels of homocysteine (Hcy) and anti-phospholipid antibodies (APLA) in the hematoplasma of the patients with deep venous thrombosis (DVT), discuss the reason of DVT recurrence and search for the predictors of it. MethodsSixty cases with DVT in our department from January 2001 to April 2003 were collected, which were divided equally into two groups as primary and recurrent, and first degree relative of the 30 DVT recurrent patients were also collected. The author established a control group using 30 cases of outpatient clinic without varicose veins of lower extremity or insufficient venae profundae. Hcy was detected with fluorescence polarization immunoassay (FPIA) and APLA 〔anticardiolipin antibody, ACLA (IgG, IgM); lupus antibody (LA)〕were detected with enzyme linked immunosorbent assay (ELISA). Odds ratios (OR) were also calculated to assess the relative risk of each study group. ResultsThe values of Hcy and ACLA （IgG， IgM） in the primary group and recurrent group were both significantly higher than those of control group and first degree relative group of DVT recurrent patients (Plt;0.01). The values of Hcy in first degree relative group of DVT recurrent patients was were also much higher than that of control group (Plt;0.05). The 90% quantity of Hcy in control group was 13.1 μmol/L and if taking it as the normal value, the number of cases exceeded this value in primary group, recurrent group and first degree relative group of DVT recurrent patients were 14, 21 and 13 and the OR of them were 2.31, 2.20 and 1.90, respectively. The positive rates of LA were not statistically significant in each group. Conclusion The values of Hcy and APLA both rise in the hematoplasma of DVT patients. There are close relationship between the levels of Hcy and APLA and DVT. The recurrence of DVT is related to high level of Hcy and Hcy is possibly a predictor of DVT.
【摘要】 目的 探討經腋靜脈穿刺中央靜脈置管后上肢深靜脈血栓形成情況。 方法 2007年1月-2009年12月共收治60例需行中央靜脈置管的患者，所有患者均通過腋靜脈穿刺行中央靜脈插管，并于拔除導管后行彩色多普勒超聲檢查了解雙側上肢深靜脈血栓形成情況。將腋靜脈穿刺側上肢作為穿刺組，對側上肢作為對照組，進行前瞻性對照研究，將兩組上肢深靜脈血栓發生率進行比較。 結果 60例患者中央靜脈置管平均時間為（14.7±7.4） d，對照組彩色多普勒超聲檢查無深靜脈血栓形成，穿刺組2例患者出現上肢深靜脈血栓形成的癥狀，無肺栓塞發生，28例患者（47%）拔除的導管周圍可見纖維蛋白套形成，經上肢彩色多普勒超聲檢查，5例患者（8.3%）腋靜脈不完全栓塞，2例患者（3.3%）腋靜脈完全栓塞。在中央靜脈置管時間≤6 d的患者中，無上肢深靜脈血栓形成；置管時間在7~14 d的患者中，2例（3.3%）腋靜脈血栓形成；5例（8.3%）腋靜脈血栓形成發生在置管時間≥15 d（Plt;0.01）。7例腋靜脈血栓形成患者，經2~3次穿刺成功，平均穿刺時間（10±2.5） min，與無腋靜脈血栓形成患者的平均穿刺所需時間（14±9）min比較，無統計學意義（Pgt;0.05）。 結論 經腋靜脈穿刺中央靜脈置管后上肢深靜脈血栓形成的發生率為11.6%。【Abstract】 Objective To determine the frequency of central venous catheter-induced thrombosis of the axillary vein. Methods Sixty patients in a medical-surgical intensive care unit who required central venous catheterization via the axillary vein from January 2007 to December 2009 were selected. On catheter removal, color doppler ultrasonography examination was performed on all the patient. The incidence of deep vein thrombosis in catheterized arms was compared with that in uncatheterized arms. This study was designed by prospective controlled study. Results Catheters were inserted for a mean duration of (14.7±7.4) days. Sixty patients who underwent axillary vein cannulation, one patient had clinical signs of arm vein thrombosis, and no patient had clinical sign of pulmonary embolism. Fibrin sleeves that developed around the catheters were observed in 28 patients (47%). Five patients (8.3%) had phlebographic signs of partial axillary vein thrombosis:nonobstructive clots adherent to the vessel wall and (or) the catheter. Two patients (3.3%) had color doppler ultrasonography signs of complete axillary vein thrombosis. No thrombosis was observed in patients with catheterizations lasting ≤6 days, two cases were observed for duration of 7-14 days, and five cases were observed for duration of ≥15 days (Plt;0.01). In seven patients with axillary vein thrombosis, the vessel was cannulated with fewer than three puncture attempts, and the mean duration for catheter insertion (10±2.5) minutes didn’t differ much from that of patients with no axillary vein thrombosis (14±9) minutes. Conclusion The axillary vein catheterization is associated with 11.6% frequency of upper-extremity deep vein thrombosis.
摘要:目的： 分析肺動脈血栓栓塞癥（PTE）的臨床特征、診斷方法及治療。提高診斷率和治愈率,改善預后。 方法 ：回顧分析我院過去七年間收治的25例PTE患者的危險因素、臨床表現、輔助檢查、治療情況等臨床資料。 結果 ：PTE的危險因素有深靜脈血栓、高齡、心肺疾病、長期臥床等慢性基礎疾病以及近期手術、外傷史等。其臨床表現各異,D-二聚體、CT肺動脈造影（CTPA）敏感性高。 結論 ：PTE臨床表現多樣,D-二聚體可作為篩選檢查首選;CTPA可作為無創檢查之首選。確診后正確及時治療可使預后顯著改善。Abstract: Objective: to analyze the clinical character\ methods of diagnosis and therapies of pulmonary thrombus embolism, to improve the precisions of diagnosis and therapy, to make prognosis better. Method : 25 patients of pulmonary thrombus embolism admitted in our hospital in the past seven years, were analyzed by risk factors, clinical manifestation accessory examination and therapies. Result : risk factors of pulmonary thrombus embolism included thrombus in venue profound, senility the diseases of heart and lung, keeping in the bed for a long time, above clinic diseases, operation and trauma in the near future their clinical manifestations were different, the sensitivity of dipolymer and CT pulmonary arteriography were high. Conclusion : clinical manifestations of pulmonary thrombus embolism were various, dipolymer may be regarded as the firster to diagnbose pulmonary thrombus embolism, CT pulmonary arteriography may be regarded as the first non-traumatogenic examination to diagnose pulmonary thrombus emboklism. After the diagnosis, correct therapies in time can greatly improver prognosis.