莱登V因子保护心脏手术后的血液流失和输血
Brian S Donahue1, David Gailani, Michael S Higgins
1Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tenn 37232, USA. brian.donahue@vanderbilt.edu
Circulation
|February 26, 2003
概括
在心脏手术后,V因子莱登 (FVL) 携带者经历的血液损失显著减少. 这种共同的遗传特征可以提供对输血的保护,强调了遗传变异性在手术结果中的作用.
科学领域:
- 心血管外科心血管外科
- 遗传学 是一个遗传学.
- 血液学 血液学 血液学
背景情况:
- 心脏手术的结果是多因素的,对特定的遗传变异的探索有限.
- 在心脏外科手术过程中,保护血液是一个关键问题.
- 因子V莱登 (FVL) 多态是凝血因子的一个常见的遗传变异.
研究的目的:
- 调查因子V莱登 (FVL) 多态化对心脏手术患者的血液损失和输血需求的影响.
- 为了测试FVL可能提供保护过度出血和需要输血的假设.
主要方法:
- 分析了接受心脏手术的517名患者的队列.
- 这项研究包括26名异构体FVL携带者.
- 使用单变量和多变量回归技术来评估FVL对胸管输出量和输血率的影响.
主要成果:
- 与非携带者相比,患有FVL的患者在手术后6小时和24小时的血液损失显著降低 (P<0.001和P=0.001).
- 在多变量分析中,FVL被确定为减少血液损失的独立预测因子.
- 虽然FVL没有显著影响输血单位的数量,但它显示出对接受任何输血的整体风险有显著的保护作用.
结论:
- 激素V莱登多态 (FVL) 是一种普遍的遗传特征,可能会在心脏手术患者中保护他们免受血液损失和输血需求.
- 这项研究强调了遗传变异对心脏手术后患者结果的影响.
相关概念视频
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Introduction to Hemostasis
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...
Coagulation
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
Extrinsic and Intrinsic Pathways of Hemostasis
Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which forms a...
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which forms a...
Clot Retraction and Fibrinolysis
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...


