由粉样蛋白-纤维素原聚合物定义的微血块预测了传播的血管内凝血和死亡的风险
Jeremy Schofield1,2, Simon T Abrams1,3, Rosalind Jenkins4
1Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.
Blood advances
|March 20, 2024
概括
在重症患者中发现了被确定为粉样蛋白-纤维素聚合物的微血块,并与败血症有关. 它们的存在和大小可以预测传播的血管内凝血和死亡风险.
科学领域:
- 生物化学 生物化学
- 血液学 血液学 血液学
- 临界护理医学 临界护理医学
背景情况:
- 微结块,潜在的粉样蛋白-纤维素聚合物,与各种疾病有关,包括COVID-19后综合征.
- 它们作为生物标志物的预后价值尚未得到充分证实.
- 了解微结块的形成和临床意义对于重症患者至关重要.
研究的目的:
- 研究微血块作为危重病患者的预后生物标志物的临床实用性.
- 确定微血栓与败血症,传播性血管内凝血 (DIC) 和死亡率之间的关联.
- 为了描述微积分的组成.
主要方法:
- 血液样本从104名危急病患者中收集,这些患者在接受ICU治疗后96小时内接受了血液样本.
- 在缺乏血小板的血中检测和量化了微血块,使用黄素T染色和光显微镜,辅助Image J软件.
- 使用多色免疫光和蛋白质组分析来确定微结块的组成.
主要成果:
- 在入院时,在42.3%的ICU患者中检测到微血块,而在健康对照组中为0%.
- 入院时微血块的存在与败血症的初级诊断有显著的关联 (P = .044).
- 较高的微结块负担 (数量/大小) 与发展DIC的可能性增加相关 (OR,51.4;P <.001) 和较高的28天死亡率 (OR,5.3;P <.001).
结论:
- 微血块,特征为粉样蛋白-纤维素聚合物,存在于严重病患者的很大一部分.
- 微血块检测可以帮助识别败血症.
- 微凝块的存在和负担是预测ICU中不良凝血病结果和死亡率的有价值指标.
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