入院粘弹性静血检测参数预测长期脑内出血的不良结果
Laura Sieh1, Emma Peasley1, Eric Mao1
1Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA.
Neurocritical care
|July 2, 2024
概括
像ROTEM这样的粘弹性静血测试 (VHA) 可以预测脑内出血 (ICH) 的不良结果. 入院时凝血速度较慢和凝血强度较弱与ICH患者的长期结果较差有关.
科学领域:
- 神经学 神经学
- 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:
- 粘弹性静血测试 (VHA) 提供了全面的凝血评估,有助于控制出血的治疗方法.
- 在大脑内出血 (ICH) 中VHA的实用性仍然在很大程度上未被探索.
- 调查VHA与ICH结果的相关性可以为治疗策略提供信息.
研究的目的:
- 确定粘性弹性静血试验 (VHA) 参数是否与自发性脑内出血 (ICH) 患者的长期结果相关.
主要方法:
- 一个单一中心的队列研究包括44名自发性ICH患者,他们接受了旋转血栓等位测量 (ROTEM) VHA测试.
- 排除标准包括先前使用抗凝剂或基线凝血病.
- 后勤回归分析了ROTEM参数 (凝血动力学,凝块强度) 和6个月后修改的兰金度表 (mRS) 评分之间的关联,并根据ICH严重程度和血红蛋白进行调整.
主要成果:
- 64%的患者经历了6个月的不良结果 (mRS ≥4).
- 延长的凝血动力学 (较长的凝血形成时间) 与不良的长期结果相关 (aOR1.04,P=0.04).
- 较弱的凝块强度 (较低的最大凝块牢固度) 也与糟糕的结果有关 (aOR 0.84,P=0.03).
结论:
- 入院VHA ROTEM测试显示,较慢的凝血动力学和较弱的凝血强度与ICH患者的长期不良结果有关,独立于抗凝剂的使用.
- 需要进一步的研究来验证这些发现,阐明机制,并探索VHA引导治疗在ICH护理中的整合.
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