纤维蛋白原治疗对血液科低纤维蛋白原血症患者的影响  

Impacts of fibrinogen therapy on patients with hypofibrinogenemia in department of hematology

作　　者：蒋玉霞 苏传勇[1] 陶叠宏[1] 吴海英 蒋慧芳[1] 魏克民[1] JIANG Yuxia;SU Chuanyong;TAO Diehong;WU Haiying;JIANG Huifang;WEI Kemin(Department of Hematology,Tongde Hospital of Zhejiang Province,Hangzhou310012,China)

机构地区：[1]浙江省立同德医院血液科,浙江杭州310012

出　　处：《中国现代医生》2020年第28期22-25,共4页China Modern Doctor

基　　金：浙江省医学会临床科研基金项目(2017ZYC-A08);浙江省基础公益研究计划项目(LQY19H080001)。

摘　　要：目的探讨纤维蛋白原对血液科低纤维蛋白原血症患者的临床疗效及预后分析。方法选取2018年1月~2019年1月我院血液科收治的60例低纤维蛋白原血症患者,随机分为两组,每组各30例。两组患者均予常规对症治疗,在此基础上治疗组加用纤维蛋白原2~4 g静脉滴注,q72h,直至纤维蛋白原水平≥2 g/L停止输注。对照组予输注同等体积的血浆治疗,(15~20)mL/kg,q72h。分别于治疗前(D0)、D3、D6、D14检测血浆纤维蛋白原浓度,评估出血情况,继续随访1周,观察并记录各组患者的住院时间及病死率。结果(1)输注前两组血浆纤维蛋白原水平、出血评分比较,差异无统计学意义。(2)输注后D3、D6、D14治疗组的纤维蛋白原水平、出血评分与对照组比较,差异有统计学意义(P<0.05),且维持纤维蛋白原水平>1.5 g/L,患者出血风险减少,可能获益更多。(3)输注后治疗组住院时间较对照组减少,差异有统计学意义(P<0.05),治疗组与对照组病死率比较,差异无统计学意义(P>0.05)。结论补充纤维蛋白原能有效提高低纤维蛋白原血症患者的纤维蛋白水平,改善出血情况,减少住院时间,但不能降低病死率,且维持纤维蛋白原水平>1.5 g/L可能使患者获益更多。Objective To investigate the clinical efficacy and prognosis of fibrinogen therapy on patients with hypofibrinogenemia in the department of hematology.Methods A total of 60 patients with hypofibrinogenemia admitted to the department of hematology in our hospital from January 2018 to January 2019 were selected and randomly divided into the treatment group(n=30)and the control group(n=30).Both groups of patients were given conventional symptomatic treatment,while the treatment group was given 2~4 g intravenous infusion of fibrinogen,q72h,until the fibrinogen level was≥2 g/L on the basis of conventional symptomatic treatment,then the infusion was stopped.The control group was given the same volume of plasma,15~20 mL/kg,q72h.Plasma fibrinogen concentration was determined before treatment,D3,D6 and D14,and hemorrhage was evaluated.Follow-up was continued for 1 week,and the hospitalization time and mortality rate of patients in each group were observed and recorded.Results(1)Before infusion,there were no statistically significant differences in plasma fibrinogen level and hemorrhage score between the two groups.(2)After infusion,the fibrinogen level and hemorrhage score in the treatment group on D3,D6 and D14 were significantly different from those in the control group(P<0.05),and the fibrinogen level was maintained above 1.5 g/L,thus reducing the risk of hemorrhage and possibly benefiting more.(3)After infusion,the hospitalization time in the treatment group was shorter than that in the control group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference in mortality rate between the treatment group and the control group(P>0.05).Conclusion Supplementing fibrinogen can effectively increase the fibrinogen level of patients with hypofibrinogenemia,improve hemorrhage and reduce hospitalization time,but it cannot reduce the mortality rate.Meanwhile,maintaining fibrinogen level>1.5 g/L may benefit the patients more.

关 键 词：低纤维蛋白原血症 纤维蛋白原 脓毒症 急性早幼粒细胞白血病 急性淋巴细胞白血病 

分 类 号：R554[医药卫生—血液循环系统疾病]