使用标准凝血试验和全血血栓凝血仪对症患者和健康对照人群的血液静止的比较评估
Ecaterina Scarlatescu1, Paul Y Kim2, Sergey P Marchenko3
1Carol Davila University of Medicine and Pharmacy, Eroii Sanitari 8, Bucharest 050474, Romania; Department of Anesthesia and Intensive Care III, Fundeni Clinical Institute, 258 Fundeni Street, Bucharest 322028, Romania.
概括
标准的凝血试验可能表明败血症患者是低凝血的,但旋转血栓凝血计显示出正常的启动和血块强度的增加. 败血症涉及复杂的静血变化超出标准测试能力.
科学领域:
- 凝血和血栓形成的原因
- 临界护理医学 临界护理医学
- 血液学 血液学 血液学
背景情况:
- 败血症破坏了身体血液凝固,抗凝固和凝块分解的自然平衡.
- 了解这些复杂的静血变化对于有效的败血症管理至关重要.
研究的目的:
- 在评估早期败血症患者的凝血时,将旋转性血栓形成测试 (ROTEM) 与标准凝血测试 (SCT) 进行比较.
- 使用这两种方法来评估血栓形成,稳定和败血症中的溶解.
主要方法:
- 一项观察性研究涉及30名败血症患者 (SP) 和30名健康对照人群 (HC).
- 在进入研究时进行了标准凝血试验 (SCT) 和ROTEM分析.
- 一种经过修改的ROTEM试验,添加了组织等离子体激活剂 (tPA),评估了纤维解质耐药性.
主要成果:
- 败血症患者与对照人群相比,表现出更长的前列血时间,更高的纤维素原和更低的血小板.
- 在大多数败血症患者中,ROTEM显示出正常的凝血开始,并增强了凝血形成,性和弹性.
- 败血症患者表现出较高的凝块溶解耐药性,原生样本和tPA-spiked样本之间的溶解差异小于对照样本.
结论:
- 旋转性血栓形成仪 (VET) 提供了比标准凝血测试 (SCT) 更全面的血液静止的视图.
- 尽管SCT显示出高凝血性,但VET显示出正常的初始凝血,凝血强度增加,血小板媒介收缩和败血症溶解减少.
- ROTEM提供了更深入的洞察力,了解发生在败血症期间的动态静血性变化.
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