与COVID-19患者相关的常见凝血病
Vinish Gupta1, Sourya Acharya1, Akshunna Keerti1
1Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus
|May 26, 2023
概括
患有严重疾病或并发症的COVID-19患者面临更糟糕的结果,通常显示D-二次体水平升高. 了解凝血变化对于管理冠状病毒疾病2019中的血栓形成和出血风险至关重要.
科学领域:
- 医学研究 医学研究
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 2020年3月由世卫组织宣布的COVID-19大流行病已经出现了与并发病相关的严重病例和更糟糕的预后.
- 在COVID-19患者中经常观察到升高的D-二聚合物水平,这表明凝血和纤维溶解异常.
- 鉴于D-二聚体评估的实用性有限,由于潜在的快速变化,需要进行常规的凝血监测.
研究的目的:
- 为了调查COVID-19患者的凝血和纤维素分解状态.
- 了解COVID-19相关血栓瘤中凝血指标的诊断相关性.
- 为了区分COVID-19凝血病与败血症相关的传播性血管内凝血 (DIC).
主要方法:
- 在住院COVID-19患者中分析凝血和纤维溶解指标.
- 在COVID-19和细菌性败血症之间对凝血概况的比较.
- 评估凝血病的潜在原因,包括缺氧,内皮损伤和免疫反应.
主要成果:
- 与败血症相比,COVID-19表现出明显的凝血病,延长前体血时间的流行率较低,激活的部分血栓塑时间和抗血活性降低.
- 宏观和微型血栓形成是使用凝血和纤维溶解指标诊断的关键特征.
- 虽然出血很少见,但COVID-19的确切血栓风险和最佳预防策略仍然不确定.
结论:
- COVID-19凝血病的病理生理学是复杂的,涉及缺氧,内皮损伤和免疫失调.
- 针对COVID-19的治疗策略应解决抗病毒,抗炎 (细胞因子风暴) 和抗血栓需求.
- 未来的研究可能会专注于组合疗法,如肝素和nafamostat,以改善结果.
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