肥胖和凝血:通过先进的成像分析预测伤害后凝血
James B Littlejohn1, Emily E Grenn1, Kristen T Carter2
1Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi.
The Journal of surgical research
|August 26, 2023
概括
皮下脂肪与psoas肌肉比率 (SP比率) 比标准的肥胖测量更好地预测创伤患者的高凝血能力. 这种CT-derived measure of sarcopenic obesity可以优化受伤,肥胖患者的血栓预防策略.
科学领域:
- 创伤研究研究创伤研究
- 肥胖和新陈代谢
- 凝血科学是一门凝血科学.
背景情况:
- 脂肪组织的分布与高凝固性有着可变的联系.
- 标准的肥胖指标显示,与受伤后的高凝血能力存在不一致的关联.
- 计算机断层扫描 (CT) 扫描提供了详细的身体成分分析.
研究的目的:
- 评估CT衍生的人类测量和体积脂肪度测量作为伤害后高凝血能力的预测指标.
- 在创伤患者中探索身体组成指标和血栓形成显微镜 (TEG) 之间的关联.
- 为了确定最佳的基于成像的标记物来预测受伤后的凝块强度.
主要方法:
- 对一组潜在的严重受伤患者的回顾性分析.
- 抵达CT扫描的细分分析以确定人体测量 (腰围,腹直径) 和体积测量 (内脏脂肪组织,皮下脂肪组织,肌肉体积) 参数.
- 探索这些测量和TEG参数之间的关联,特别是最大幅度 (MA).
主要成果:
- 在体质指数,标准人体测量和脂肪组织体积之间发现了强烈的相关性.
- 皮下脂肪与psoas肌肉 (SP) 的比率与TEG-MA (r=0.340,P=0.005) 显示出中等,显著的相关性.
- SP比率独立预测了损伤后凝块强度/稳定性的增加,即使经过损伤严重程度和乳酸水平的调整.
结论:
- 在受伤患者中,SP比率是高凝血能力的更强的预测指标,而不是标准的肥胖度.
- 可以量化和利用CT衍生的sarcopenic肥胖的措施.
- 这些发现可能会为肥胖的创伤患者提供优化的血栓预防策略.
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