9.Study on the risk factors of deep venous thrombosis in acute hospitalized stroke patients.
Kui-Kui SUN ; Chen WANG ; Bao-Sen PANG ; Yuan-Hua YANG ; Wen HE ; Tian-Feng CHEN ; Qi-Huang ZHAO ; Jian ZHANG
Chinese Journal of Epidemiology 2004;25(12):1019-1023
OBJECTIVETo identify the risk factors of deep venous thrombosis (DVT) in hospitalized patients with acute stroke, under a perspective case-control study.
METHODS488 cases with stroke, identified by CT or MRI and admitted to the department of neurology and neurosurgery in Beijing Chaoyang Hospital between December 2001 and December 2002 were consecutively studied. There were 328 male and 160 female patients (95.5% Hans) with a mean age of 65 +/- 11 years, ranging 22 - 93 years. The procedure of study would include: (1) General condition, possible risk factors, symptoms of DVT physical check-up to every eligible patient on first day of admission but the plasma concentrations of D-dimer (ELISA), thrombomodulin, antithrombin-III and blood routine examination were measured on the next morning. (2) The ultrasonography (US) was used for detecting both lower extremities at 7 - 10 days after the onset of stroke, and D-dimer and AT-III tests were repeated on the same or next day that the US was taken. (3) The ultrasound examination was repeated after a week in patients with high suspicion of DVT. (4) The therapy of stroke was recorded before the end of the study. Data of stoke patients with DVT was compared with those without DVT to identify the DVT risk factors. The effect of each variable on DVT was assessed by logistic regression analysis.
RESULTSThe prevalence of DVT was 21.7% among the patients. In multivariate analysis, age >/= 65 years old (OR = 1.655, 95% CI: 1.005 - 2.725), being male (OR = 1.993, 95% CI: 1.221 - 3.253), bedridden (OR = 3.275, 95% CI: 1.653 - 6.486) and DVT assessment scores >/= 2 (OR = 5.019, 95% CI: 2.685 - 9.381) were independently associated with DVT in all the stroke patients. Being male (OR = 2.828, 95% CI: 1.242 - 6.438), white blood cell count > 10.0 x 10(9)/L (OR = 2.032, 95% CI: 0.897 - 4.602) and DVT assessment scores >/= 2 (OR = 8.809, 95% CI: 3.081 - 25.188) were the independent risk factors of DVT in hemorrhagic stroke group. Age >/= 65 years old (OR = 2.167, 95% CI: 1.072 - 4.381), bedridden (OR = 3.008, 95% CI: 1.435 - 6.307) and DVT assessment scores >/= 2 (OR = 2.600, 95% CI: 1.077 - 6.278) were the independent risk factors of DVT in ischemic stroke group.
CONCLUSIONPatients hospitalized with acute stroke were under high risk of DVT. Data suggested that old age, female, bedridden and high DVT assessment scores >/= 2 were independent risk factors for DVT in acute stroke patients that called for supervision and prophylaxis on DVT.
Aged ; Case-Control Studies ; China ; epidemiology ; Female ; Hospitalization ; Humans ; Leg ; blood supply ; Male ; Prevalence ; Prospective Studies ; Risk Factors ; Stroke ; complications ; Venous Thrombosis ; epidemiology ; etiology
10.Common variable immunodeficiency: report of two cases and literature review.
Jian-ping LI ; Hui-jun WANG ; Lei ZHANG ; Ren-chi YANG ; Feng-kui ZHANG
Chinese Journal of Hematology 2009;30(2):111-114
OBJECTIVETo promote the awareness of common variable immunodeficiency (CVID).
METHODSReport two cases of CVID and review related literature.
RESULTSThe two CVID patients were manifested recurrent infections of respiratory and digestive tract, splenomegaly, significantly reduced serum immunoglobulin, since adolescence. They were treated with intravenous gammaglobulin, anti-infection and symptomatic therapies and the diseases were well controlled. Case 1 was diagnosed as with spleen peripheral T cell lymphoma after splenectomy. Case 2 developed nutritional megaloblastic anemia resulting from repeated digestive tract infections.
CONCLUSIONCVID is a heterogeneous group of diseases with later-onset, characterized by hypogammaglobulinemia and recurrent bacterial infections. Early diagnosis and regular treatment may improve the prognosis.
Common Variable Immunodeficiency ; drug therapy ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Young Adult