缺陷的全血血生成与急性不补偿性肝硬化时的手术相关出血有关
Alberto Zanetto1, Elena Campello2, Cristiana Bulato3
1Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy; Gastroenterology and Multivisceral Transplant Unit, Padova University Hospital, Padova, Italy.
Journal of hepatology
|December 13, 2024
概括
在全血中,血栓激素修饰的血栓激素生成 (TM-TG) 显示出预测无补偿性肝硬化中出血风险的前景. 然而,TM-TG并不能改善补偿性肝硬化风险分层,也不能预测血栓形成.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 凝血科学 凝血科学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 对于评估肝硬化中凝血病的血栓激素修饰生成 (TM-TG) 的临床实用性仍然不确定.
- 肝硬化显著改变凝血,需要可靠的预后工具来管理患者.
研究的目的:
- 为了前性地评估TM-TG在患者的预后价值补偿,稳定无补偿和急性无补偿肝硬化.
- 为了确定TM-TG是否可以预测出血,血栓,肝脏衰竭和与肝脏相关的死亡.
主要方法:
- 对231名肝硬化患者的前性研究 (补偿,稳定失补偿,急性失补偿).
- 在招募时进行的全血 (WB) 和低血小板血 (PPP) TM-TG.
- 随访出血,血栓形成,肝脏衰竭和与肝脏相关的死亡.
主要成果:
- 在出血患者中,WB-TG和PPP-TG发生了变化,但只有WB-TG (ETP<350nmol/L*min) 预测了急性不补偿性肝硬化 (AUC0.854) 中的主要手术相关出血.
- 无论是WB-TG还是PPP-TG都没有预测血栓形成.
- 在不补偿性肝硬化中,更高的WB-TG容量独立地与更低的进展风险 (不补偿,ACLF,肝脏相关死亡) 有关.
结论:
- 在补偿性肝硬化中,TM-TG并不能改善风险分层.
- 在不补偿性肝硬化中,WB-TM-TG是估计手术相关出血风险的有希望的工具.
- WB-TG容量独立地预测了不补偿性肝硬化病的不良结果.
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