代谢综合征与全膝关节置换术后深静脉血栓形成相关性研究

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Objective To study the correlation between the incidence of total deep vein thrombosis(DVT)and symptomatic DVT after total knee arthroplasty(TKA)and each component and quantity of the metabolic syndrome(MS).Methods 618 patients who underwent initial TKA in our department from January 2020 to December 2021 were retrospectively analyzed.MS was diagnosed according to the criteria of the Diabetes Branch of Chinese Medical Association.There were 166 male patients aged 50～81 years，with an average age of (66.94±6.90)years and 452 female patients aged 52～81 years，with an average age of (65.90±7.57)years.All patients were also divided into five groups(0MS factor group，1MS factor group，2MS factor group，3MS factor group，and 4MS factor group)based on the number of MS components achieved.All subjects underwent preoperative bilateral lower extremity vascular ultrasound to rule out preoperative lower extremity DVT，and postoperative bilateral lower extremity vascular ultrasound to screen for DVT.Clinical signs were also examined and symptomatic DVT events after TKA were recorded.Univariate and multifactorial logistic regression analyses were used to clarify the correlation between MS and its components and quantities with the incidence of total and symptomatic postoperative DVT.Results 618 patients undergoing TKA were included in this study.260 patients(42.10%)had DVT after surgeries and 49 patients(7.93%) had symptomatic DVT.In total knee arthroplasty，dyslipidemia was related with both the incidence rate of total DVT ［95% CI(1.492~3.310)，P＜0.001］ and symptomatic DVT ［95% CI(2.192~15.232)，P＜0.001］.Body mass index(BMI) ≥25 kg／m² was related with total DVT ［95% CI(0.371~0.801)，P＝ 0.027］ was related with the incidence rate of total DVT ［95%CI(0.623~4.777)，P＝0.074］and metabolic syndrome was related with the incidence rate of total DVT ［95%CI(2.221~7.384)，P＝0.042］ and not related with symptomatic DVT ［95%CI(1.036~12.575)，P＝0.077］.Conclusion Patients with MS have increased risk of the incidence rate of total DVT after total knee arthroplasty.Dyslipidemia in the MS component is an independent risk factor for the incidence rate of total DVT and symptomatic DVT after total knee arthroplasty，and overweight(BMI≥25 kg／m²) is an independent risk factor for the incidence rate of total DVT after total knee arthroplasty.The incidence rate of total DVT and symptomatic DVT after total knee arthroplasty is related to the number of MS components；the higher the number of MS components，the higher the incidence rate of total DVT and symptomatic DVT after surgery.

Key words： metabolic syndrome total knee arthroplasty deep vein thrombosis diabetes

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［1］Capuano E，Marchese F，Capuano R，et al.The burden of cardio-cerebrovascular risk factors：Differences between individual risk and population risk［J］.2021，28(6)：597-603.
［2］Kim SY，Go TH，Lee JH，et al.Differential association of metabolic syndrome and low-density lipoprotein cholesterol with incident cardiovascular disease according to sex among Koreans：A national populationbased study［J］.European J Preventive Cardiology，2022，28(18)：2021-2029.
［3］Greenfield DM，Snowden JA.Cardiovascular diseases and metabolic syndrome［M］//Carreras E，Dufour C，Mohty M，et al.The EBMT Handbook.Cham：Springer International Publishing，2019：415-420.
［4］Saely CH，Rein P，Drexel H.The metabolic syndrome and risk of cardiovascular disease and diabetes：experiences with the new diagnostic criteria from the International Diabetes Federation［J］.Hormone Metabolic Res，2007，39(9)：642-650.
［5］Xiong Y，Zhang Y，Zhang F，et al.Prevalence and related factors of metabolic syndrome in Chinese middle-aged and elderly population：A national cross-sectional study［J］.Aging Male，2021，24(1)：148-159.
［6］Liu B，Chen G，Zhao R，et al.Temporal trends in the prevalence of metabolic syndrome among middle-aged and elderly adults from 2011 to 2015 in China：the China health and retirement longitudinal study(CHARLS)［J］.BMC Public Health，2021，21(1)：1045.
［7］Xie D X，Wei J，Zeng C，et al.Association between metabolic syndrome and knee osteoarthritis：A cross-sectional study［J］.BMC musculoskeletal disorders，2017，18(1)：533.
［8］Xie Y，Zhou W，Zhong Z，et al.Metabolic syndrome，hypertension，and hyperglycemia were positively related with knee osteoarthritis，while dyslipidemia showed no association with knee osteoarthritis［J］.Clin Rheumatol，2021，40(2)：711-724.
［9］Mccracken E，Monaghan M，Sreenivasan S.Pathophysiology of the metabolic syndrome［J］.Clin Dermatol，2018，36(1)：14-20.
［10］Bovolini A，Garcia J.Metabolic syndrome pathophysiology and predisposing factors［J］.Int J Sports Med，2021，42(3)：199-214.
［11］Khunger JM，Kumar N，Punia V PS，et al.Study of prothrombotic changes in metabolic syndrome［J］.Indian J Hematol Blood Transfus，2020，36(4)：695-699.
［12］中华医学会糖尿病学分会代谢综合征研究协作组.中华医学会糖尿病学分会关于代谢综合征的建议［J］.中华糖尿病杂志，2004，12(3)：5-10.
［13］李晓强，王深明.深静脉血栓形成的诊断和治疗指南(第二版)［J］.中国血管外科杂志(电子版)，2013，5(1)：23-26.
［14］Nemeth B，Nelissen R，Arya R，et al.Preventing VTE following total hip and knee arthroplasty：Is prediction the future?［J］.J Thromb Haemost，2021，19(1)：41-45.
［15］Shahi A，Bradbury TL，Guild GN 3rd，et al.What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?［J］.Arthroplast Today，2018，4(3)：343-347.
［16］Johnson SA，Jones AE，Young E，et al.A riskstratified approach to venous thromboembolism prophylaxis with aspirin or warfarin following total hip and knee arthroplasty：A cohort study［J］.Thromb Res，2021(206)：120-127.
［17］Nadi S，Vreugdenburg TD，Atukorale Y，et al.Safety and effectiveness of aspirin and enoxaparin for venous thromboembolism prophylaxis after total hip and knee arthroplasty：A systematic review［J］.ANZ J Surg，2019，89(10)：1204-1210.
［18］He ML，Xiao ZM，Lei M，et al.Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty［J］.Cochrane Database Syst Rev，2014，29(7)：CD008207.
［19］Deng W，Huo L，Yuan Q，et al.Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty［J］.BMC Musculoskelet Disord，2021，22(1)：608.
［20］Song K，Rong Z，Yao Y，et al.Metabolic syndrome and deep vein thrombosis after total knee and hip arthroplasty［J］.J Arthroplasty，2016，31(6)：1322-1325.
［21］Ay C，Tengler T，Vormittag R，et al.Venous thromboembolism：A manifestation of the metabolic syndrome［J］.Haematologica，2007，92(3)：374-380.
［22］Dentali F，Romualdi E，Ageno W.The metabolic syndrome and the risk of thrombosis［J］.Haematologica，2007，92(3)：297-299.
［23］Ambrosetti M，Ageno W，Salerno M，et al.Metabolic syndrome as a risk factor for deep vein thrombosis after acute cardiac conditions［J］.Thromb Res，2007，120(6)：815-818.
［24］Griffin JH，Fernández JA，Deguchi H.Plasma lipoproteins，hemostasis and thrombosis［J］.Thromb Haemost，2001，86(1)：386-394.
［25］Mantilla C B，Horlocker T T，Schroeder D R，et al.Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty［J］.Anesthesiology，2003，99(3)：552-560.
［26］Zhang J，Chen Z，Zheng J，et al.Risk factors for venous thromboembolism after total hip and total knee arthroplasty：A metaanalysis［J］.Arch Orthop Trauma Surg，2015，135(6)：759-772.
［27］Dentali F，Squizzato A，Ageno W.The metabolic syndrome as a risk factor for venous and arterial thrombosis［J］.Semin Thromb Hemost，2009，35(5)：451-457.
［28］Ageno W，Prandoni P，Romualdi E，et al.The metabolic syndrome and the risk of venous thrombosis：A case-control study［J］.J Thromb Haemost，2006，4(9)：1914-1918.

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