作为儿童患者因子VII凝血活动的预测者,前列血时间和国际规范化比率
Yotam Bronstein1, Dana Elhadad1, Eyas Midlij1
1Department of Pediatrics, Sanz Medical Center-Laniado Hospital, Netanya, Israel.
The Israel Medical Association journal : IMAJ
|June 29, 2023
概括
诊断第七因子 (FVII) 缺乏症需要直接测量FVII:C水平,因为标准前列血时间 (PT) 和国际正常化比率 (INR) 测试在接受手术的儿科患者中是不可靠的预测指标.
科学领域:
- 血液学 血液学 血液学
- 儿科手术 儿科手术
- 凝血障碍 凝血障碍 凝血障碍
背景情况:
- 第七因子 (FVII) 缺乏症表现为正常激活的部分血栓形成时间 (aPTT) 和延长的前列血栓时间 (PT).
- 诊断依赖于第七因子凝血活动 (FVII:C) 测量,这是昂贵和耗时的.
- 识别FVII缺陷对于管理出血风险至关重要,尤其是在手术前.
研究的目的:
- 在接受耳鼻喉科手术的儿科患者中调查PT,INR和FVII:C之间的相关性.
- 探索其他可能更简单的方法,以在手术前确定FVII缺陷.
- 评估PT和INR对FVII缺陷的预测准确度. 在这个队列中.
主要方法:
- 对96名患有正常aPTT和延长PT的儿科患者进行了回顾性分析,这些患者正在接受手术前凝血工作 (2016-2020年).
- 收集的FVII:C数据与PT和INR值一起.
- 利用斯皮尔曼相关性和接收机操作特征 (ROC) 曲线分析来评估PT和INR作为FVII缺陷的预测因素.
主要成果:
- 在FVII:C和PT和INR之间发现了显著的负相关性.
- 虽然ROC分析显示PT (0.653) 和INR (0.669) 的统计学显著结果,但没有确定高灵敏度和特异性的最佳切断点.
- 67.7%的患者有正常的FVII:C,而32.3%的患者的水平下降.
结论:
- 仅靠前列血时间 (PT) 和国际正常化比率 (INR) 就不足以可靠地预测临床相关的第七因子凝血活性 (FVII:C) 水平.
- 当PT异常时,需要直接测量FVII:C来诊断FVII缺乏.
- 准确的FVII:C水平对于在疑似或确诊的FVII缺乏症患者中确定适当的外科预防治疗至关重要.
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