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热中风引起的凝血病中的血小板功能障碍:一项回顾性观察性研究
Yuri Endo1, Ryota Inokuchi2, Miyuki Yamamoto1
1Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
血小板功能障碍在热中风引起的散布性血管内凝血 (DIC) 中很常见. 血栓形成显微镜 (TEG) 有效地评估血小板功能,有助于了解热中风亚型和DIC严重程度.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 紧急医疗 紧急医疗
背景情况:
- 严重的热中风经常导致传播性血管内凝血 (DIC).
- 了解血小板功能在热中风相关的DIC中的作用对于患者管理至关重要.
- 血栓形成显微镜 (TEG) 提供了一种评估凝血和血小板功能的方法.
研究的目的:
- 在热中风患者中使用TEG评估血小板功能.
- 为了将血小板功能与热中风患者的DIC严重程度相关联.
- 为了确定TEG在热中风中诊断DIC的实用性.
主要方法:
- 追溯的队列研究31个热中风患者入住了ICU.
- 血小板功能通过引用的功能性纤维素因子最大幅度 (CFF-MA) 和通过TEG引用的快速TEG最大幅度 (CRT-MA) 之间的差异来评估.
- 基于日本急性医学协会得分 (≥4) 的DIC诊断.
主要成果:
- 通过CFF-MA-CRT-MA测量的血小板功能与DIC得分有显著的相关性 (R = -0.63,p < 0.001).
- 基于TEG的血小板功能评估显示,与DIC发展有很强的关联 (AUC0.87).
- 血小板功能的中位数为34.4毫米 (IQR:27.8-37.8毫米).
结论:
- 血小板功能障碍是热中风引起的DIC的一个关键特征.
- TEG为评估热中风中血小板功能提供了有价值的补充信息.
- 这种评估可以提高对热中风亚型和DIC病理生理学的理解.
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