急性创伤性凝血病不同预后患者外周血APC、vWF、D-D水平变化及意义

发布时间：2018-02-01 18:39

本文关键词： 急性创伤性凝血病活化蛋白C 血管性假血友病因子 D二聚体　出处：《山东医药》2017年34期 　论文类型：期刊论文

【摘要】：目的观察急性创伤性凝血病(ATC)不同预后患者外周血活化蛋白C(APC)、血管性假血友病因子(vWF)、D二聚体(D-D)水平变化,并探讨其临床意义。方法选取ATC患者119例,根据患者预后不同分为存活组89例、死亡组30例;取两组入院24 h内外周血,酶联免疫吸附法检测血清APC,采用电化学发光检测血浆vWF、D-D;收集患者资料,采用Logistic回归分析ATC患者预后的危险因素。结果存活组入院24 h血清APC为(3.15±1.22)ng/m L、血浆vWF为178.9%±36.3%、血浆D-D为(186.4±39.0)ng/m L;死亡组血清APC为(3.98±1.40)ng/m L、血浆vWF为228.4%±48.7%、血浆D-D为(214.9±32.8)ng/m L,两组比较差异均有统计学意义(P均0.05)。Logistic回归分析显示,外周血APC(OR=1.492,95%CI 1.313~4.604,P=0.045)、vWF(OR=1.387,95%CI 1.195~3.851,P=0.035)、D-D(OR=1.525,95%CI 1.264~5.175,P=0.043)水平升高是ATC患者预后不良的独立危险因素(P均0.05)。结论 ATC不良预后患者外周血APC、vWF、D-D水平显著升高,检测三者水平有利于ATC患者的预后判断。
[Abstract]:Objective to observe the changes of peripheral blood activating protein (APC) and von Willebrand factor (vWF) D dimer (D-D) in patients with acute traumatic thromboplasmosis (ATC) with different prognosis. Methods 119 patients with ATC were divided into survival group (89 cases) and death group (30 cases) according to their prognosis. The serum APCs were detected by enzyme-linked immunosorbent assay (Elisa) and the plasma vWFT-D was detected by electrochemiluminescence (ECL). The data of patients were collected and the prognostic factors of ATC patients were analyzed by Logistic regression analysis. Results the serum APC in survival group was 3.15 卤1.22 ng / mL at 24 h after admission. Plasma vWF was 178.9% 卤36.3%, plasma D-D was 186.4 卤39.0 ng / mL; In the dead group, the serum APC was 3.98 卤1.40 ng / mL, and the plasma vWF was 228.4% 卤48.7%. The plasma D-D was 214.9 卤32.8 ng / mL, and the difference between the two groups was statistically significant (P < 0.05). Logistic regression analysis showed that there was no significant difference between the two groups. The peripheral blood APC ORA was 1.492c95, CI 1.31344.604, P0. 045 / vWFN 1.387. 95 CI 1.195 / 3.851C / P 0.035 / D / D OR1.52595 / CI 1.264 / 5.175. Conclusion the elevated level of ATC is an independent risk factor for poor prognosis in patients with ATC. Conclusion\\\ conclusion\\\;\\\; The level of D-D was significantly increased, and detection of the three levels was beneficial to the prognosis of patients with ATC.
【作者单位】：石家庄市第三医院;
【基金】：河北省石家庄市科学技术研究与发展指导计划立项(164629)
【分类号】：R641
【正文快照】： 急性创伤性凝血病(ATC)是临床上较常见的外伤性疾病,在车祸、斗殴等强力外伤的作用下,机体应激功能障碍,从而引起凝血功能、纤维蛋白溶解系统及抗纤溶系统的紊乱,加剧了凝血功能异常导致的出血性疾病、休克等的发生[1,2]。活化蛋白C(APC)、血管性假血友病因子(v WF)、D二聚体(

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