ヤマキ　タカシ   八巻　隆    所属   医学部 医学科（附属足立医療センター）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prognostic impact of calf muscle near-infrared spectroscopy in patients with a first episode of deep vein thrombosis.
掲載誌名	正式名：Journal of thrombosis and haemostasis : JTH 略　 称：J Thromb Haemost ISSNコード：1538-7836(Electronic)1538-7836(Linking)
巻・号・頁	7(9),pp.1506-13
著者・共著者	Yamaki T, Nozaki M, Sakurai H, Kikuchi Y, Soejima K, Kono T, Hamahata A, Kim K
担当区分	筆頭著者
発行年月	2009/09
概要	BACKGROUND:The risk factors that affect the development of post-thrombotic syndrome (PTS) are not fully recognized, and it is difficult to reliably predict which patients are likely to develop PTS in acute phase of deep vein thrombosis (DVT).AIMS:To investigate changes in calf muscle deoxygenated hemoglobin (HHb) levels after DVT, and to determine the indicative parameters reflecting the progression of PTS. Methods: Seventy-six consecutive patients with a first episode of unilateral DVT were prospectively enrolled. Clinical manifestations were categorized according to the CEAP (Clinical, Etiologic, Anatomical, and Pathophysiologic) classification, and the patients were divided into no-PTS (C(0-3)E(s),A(s,d,p),P(r,o)) and PTS (C(4-6)E(s),A(s,d,p),P(r,o)) groups. Near-infrared spectroscopy (NIRS) was used to measure calf muscle HHb levels at 6 months after diagnosis of DVT. The calf venous blood filling index (HHbFI) was calculated on standing, and the venous ejection index and the venous retentAIMS:ion index (HHbRI) were then obtained after exercise. All patients were followed up for more than 24 months after the diagnosis of DVT.RESULTS:Of 76 patients evaluated, 20 (26.3%) had PTS. The NIRS-derived HHbFI and HHbRI were significantly increased in patients who developed PTS in comparison with those who did not (P = 0.04 and P = 0.0001, respectively). HHbRI was significantly increased in patients with iliofemoral DVT in comparison with patients with calf DVT (P = 0.041). An optimal cut-off point of 2.9 for HHbRI showed the strongest ability to predict the development of PTS, with a sensitivity of 100% and a specificity of 82.1%.CONCLUSIONS:HHbRI as measured by NIRS is significantly increased in patients with iliofemoral DVT as compared with those with calf DVT. Furthermore, HHbRICONCLUSIONS:>CONCLUSIONS:2.9 is a strong predictor of the development of PTS at 6 months.
DOI	10.1111/j.1538-7836.2009.03528.x
文献番号	19552633