在COVID-19患者中进行血小板结晶学:在南非背景下进行的一项观察性研究
Bavinash Pillay1, Sarah A van Blydenstein1,2, Shahed Omar3,4
1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
African journal of laboratory medicine
|July 4, 2025
概括
血栓等图显示出潜在的成本效益替代抗Xa测试,用于监测COVID-19患者的低分子量肝素. 需要进一步的研究来确认临床效用.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 冠状病毒疾病2019 (COVID-19) 与静脉血栓栓塞的风险增加有关.
- 低分子量肝素 (LMWH) 的监测至关重要,但通常依赖于昂贵且难以获得的抗Xa (抗Xa) 测试.
- 血小板显微镜提供了一个潜在的护理点替代方案,但其在COVID-19患者中对抗Xa的性能尚未得到充分证实.
研究的目的:
- 评估在接受LMWH.治疗的COVID-19患者中血小板图参数和抗Xa水平之间的相关性.
- 评估血小板造影作为抗Xa监测的可行替代方案的潜力.
主要方法:
- 对42名接受LMWH的COVID-19患者进行了回顾性研究.
- 血液样本使用血栓等图 (测量R时间,K时间和凝血指数) 和抗Xa测试进行分析.
- 与LMWH管理相比,在三个时间点采集的样本.
主要成果:
- 研究人员观察到,抗Xa水平和血小板表参数之间存在统计学意义上的相关性.
- 在抗Xa和R时间 (rs=0.52,p=0.002) 之间发现了适度的相关性.
- 观察到抗Xa和血小板凝血指数 (rs=0.43,p=0.014) 和K时间 (rs=0.35,p=0.049) 之间的低至中等相关性.
结论:
- 血小板表参数 (凝血指数,R-时间,K-时间) 与LMWH的COVID-19患者的抗Xa水平显著相关.
- 血小板造影可能提供一种更容易获得和更具成本效益的监测方法.
- 需要对更大的队列和各种疾病概况进行进一步的研究,以确认临床效用.
相关概念视频
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
46
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
46
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
41
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
41
Pulmonary Embolism I: Introduction
50
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
50
Acute Coronary Syndrome III: Diagnostic Studies
25
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
25
Venous Thrombosis III: Interprofessional Care
26
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
26
Venous Thrombosis I: Introduction
45
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
45


