肝硬化进展与通过血小板造影评估的全球血液静止的临床显著变化无关
Rareș Crăciun1,2, Alina Buliarcă1, Daniela Matei1,2
1Department of Internal Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Journal of clinical medicine
|November 9, 2024
概括
标准的凝血测试很难反映出肝硬化中的血液静止. 血小板造影显示凝血平衡保持,这表明标准测试不应该指导这些患者的血液产品的使用.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 血液学 血液学 血液学
- 凝血科学 凝血科学
背景情况:
- 肝硬化经常出现异常的标准凝血测试,这些测试不能准确地代表血静.
- 血栓形成显微镜 (TEG) 提供了对凝血的全面评估,评估凝血因子,纤维素原,血小板和纤维素分解.
研究的目的:
- 调查肝病严重程度的增加是否与基于TEG的凝血评估中的渐进变化相关.
- 为了将TEG发现与肝硬化患者的标准凝血试验结果进行比较.
主要方法:
- 对连续出现异常标准凝血测试 (INR > 2,血小板 < 50 × 10^3/μL,或纤维素素 < 200 mg/dL) 的肝硬化患者的分析.
- 利用本源性血栓形成显微镜进行全球凝血评估.
- 根据使用Child-Pugh分类的肝病严重程度进行分层患者.
主要成果:
- 在106名患者中,65.1%的TEG结果正常,尽管标准测试异常.
- 与标准测试不同的是,在查尔德 - 普赫阶段没有观察到任何显著的TEG差异.
- 患有高INR或低血小板的患者通常表现出正常或高凝血TEG概况,只有4%的患者表现出低凝血.
- 一个模拟的TEG引导输血协议可以减少94.6%的血液产品指示.
结论:
- 标准凝血试验与肝硬化中TEG的相关性很差.
- 肝硬化患者,即使有严重的疾病,也经常保持血静平衡,如TEG所示.
- 与标准凝血试验相比,TEG是评估血液静止和指导肝硬化中输血决策的卓越工具.
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