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尿素度对末期脏病患者和没有末期脏病患者的血栓结石造影的体外影响
Naveen Kukreja1, Ivan E Rodriguez2, Hunter B Moore2
1Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.
American journal of surgery
|July 5, 2023
概括
末期脏疾病 (ESRD) 改变了血栓凝固显微镜 (TEG) 的结果,显示出血块强度增加和更快的凝固时间. 外源性尿素在体外没有复制这些发现,在TEG参数中注意到性别差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血液学 血液学 血液学
- 临床化学 临床化学
背景情况:
- 末期病 (ESRD) 与血小板功能障碍和血栓塞栓事件有关.
- 血尿 (BUN) 的高血对凝血的确切影响仍然不完全理解.
- 在ESRD患者中表征凝血对于管理血栓形成风险至关重要.
研究的目的:
- 与健康对照人群相比,分析ESRD的男性和女性患者的血小板造影 (TEG) 参数.
- 为了研究是否添加尿素体内可以复制ESRD患者观察到的TEG差异.
- 探索BUN水平和特定的TEG指标之间的关系.
主要方法:
- 从20名脏捐赠者 (对照组) 和20名脏接受者 (ESRD) 收集了血液样本.
- 对样本进行了血栓形成显微镜 (TEG) 测试,样本含有和没有添加不同度的尿素.
- 在接受者和捐赠者之间进行了TEG参数的统计比较,并评估了与BUN和肌素的相关性.
主要成果:
- 接受脏的人比捐赠者表现出更高的最大幅度 (MA) 和更短的最大幅度 (TMA) 时间,尽管这些在女性中并不显著.
- 在男性中,血液尿素 (BUN) 与TMA (r = -0.342) 逆相关,与MA (r = 0.583) 直接相关.
- 在体外尿素添加减少了R时间 (p=0.005) 和增加LY30 (p=0.009) 在捐赠者,但不是在接受者.
结论:
- 在TEG上,ESRD与凝块强度 (MA增加) 和凝块形成速度 (TMA减少) 的提高有关.
- 实验室尿素暴露并没有改变ESRD患者的MA,这表明其他因素有助于凝血变化.
- 在ESRD患者中观察到TEG参数的显著性别特异变化.
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