| 徐丹书,王 昀,秦 虎,张 鹏,王增亮,李绍山.凝血与纤溶指标与颅脑损伤后急性创伤性凝血病的关系及对脑心综合征的预测效能研究[J].,2024,(4):689-694 |
| 凝血与纤溶指标与颅脑损伤后急性创伤性凝血病的关系及对脑心综合征的预测效能研究 |
| Study on the Relationship between Coagulation and Fibrinolysis Indexes and Acute Traumatic Coagulopathy after Craniocerebral Injury and the Predictive Efficacy of Cerebrocardiac Syndrome |
| 投稿时间：2023-06-21 修订日期：2023-07-17 |
| DOI：10.13241/j.cnki.pmb.2024.04.018 |
| 中文关键词: TBI ATC CCS 凝血指标 纤溶指标 预测价值 |
| 英文关键词: TBI ATC CCS Coagulation index Fibrinolytic index Predictive value |
| 基金项目:新疆维吾尔自治区自然科学基金项目(2022D01244） |
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| 中文摘要: |
| 摘要 目的：分析凝血与纤溶指标与颅脑损伤（TBI）后急性创伤性凝血病（ATC）的关系及对脑心综合征（CCS）的预测效能。方法：选取2020年1月～2022年12月本院收治的80例TBI患者作为研究对象，分别检测并计算非ATC患者与ATC患者、非CCS患者与CCS患者的凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、D-二聚体（D-D）、凝血酶-抗凝血酶复合物（TAT）、纤溶酶-α2纤溶酶抑制物复合物（PIC）水平和国际标准化比值（INR）、TAT/PIC比值；并采用双变量Spearman相关性检验凝血与纤溶指标的相关性，建立多因素Logistic模型分析TBI后ATC和TBI合并CCS的影响因素，同时分析凝血与纤溶指标对TBI合并CCS的预测效能。结果：80例TBI患者的ATC发生率为27.50%；与非ATC组比较，ATC组PT、APTT、D-D水平较高，TAT/PIC比值较低（P＜0.05）。PT、APTT、D-D与颅脑损伤后ATC呈正相关性，TAT/PIC与ATC呈负相关性。多因素logistic分析结果显示，TAT/PIC是颅脑损伤后ATC的独立危险因素（P＜0.05）。80例TBI患者的CCS发生率为20.00%；与非CCS组比较，CCS组PT、APTT、D-D水平较高，TAT/PIC比值较低（P＜0.05）。多因素logistic分析结果显示，PT、APTT、D-D、TAT/PIC是TBI合并CCS的独立危险因素（P＜0.05）。TBI合并CCS预测中，PT、APTT、D-D的ACU均＞0.70，TAT/PIC＞0.85。结论：TAT/PIC与TBI后ATC存在一定关联，同时还能预测CCS的发生，在TBI患者预后预测方面具有指导意义。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the relationship between coagulation and fibrinolysis indicators and acute traumatic coagulopathy (ATC) after traumatic brain injury (TBI) and their predictive efficacy for cerebrocardiac syndrome ( CCS ). Methods: 80 patients with TBI admitted to our hospital from January 2020 to December 2022 were selected as the research objects. The levels of prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D), thrombin-antithrombin complex (TAT), plasminogen-α2 plasminogen inhibitor complex (PIC), international normalized ratio (INR) and TAT / PIC ratio were detected and calculated in non-ATC patients and ATC patients, non-CCS patients and CCS patients, respectively. Bivariate Spearman correlation was used to test the correlation between coagulation and fibrinolysis indicators.Multivariate Logistic model was established to analyze the influencing factors of ATC and TBI combined with CCS after TBI, and the predictive efficacy of coagulation and fibrinolysis indicators on TBI combined with CCS was analyzed. Results: The incidence of ATC in 80 TBI patients was 27.50 %. Compared with the non-ATC group, the levels of PT, APTT and D-D in the ATC group were higher, and the TAT / PIC ratio was lower (P<0.05). PT, APTT and D-D were positively correlated with ATC after craniocerebral injury, and TAT / PIC was negatively correlated with ATC. Multivariate logistic analysis showed that TAT / PIC was an independent risk factor for ATC after craniocerebral injury(P<0.05). The incidence of CCS in 80 TBI patients was 20.00 %. Compared with the non-CCS group, the levels of PT, APTT and D-D in the CCS group were higher, and the TAT / PIC ratio was lower (P<0.05). Multivariate logistic analysis showed that PT, APTT, D-D and TAT / PIC were independent risk factors for TBI combined with CCS(P<0.05). In the prediction of TBI combined with CCS, the ACU of PT, APTT and D-D were all > 0.70, and TAT / PIC > 0.85. Conclusion: TAT / PIC is associated with ATC after TBI, and can also predict the occurrence of CCS, which has guiding significance in the prognosis prediction of TBI patients. |
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