注射用白眉蛇毒血凝酶引起出血患者纤维蛋白原减少的相关因素分析  

Analysis of related factors of fibrinogen reduction in patients with hemorrhage caused by hemagglutinase from Baimaea venom for injection

作　　者：杨杏婷 麦建志 YANG Xingting;MAI Jianzhi(Department of Pharmacy,Xingtan Hospital,Shunde Hospital,Southern Medical University,Foshan,Guangdong 528300,China)

机构地区：[1]南方医科大学顺德医院附属杏坛医院药剂科,广东佛山528300

出　　处：《医药前沿》2021年第28期17-20,共4页Journal of Frontiers of Medicine

基　　金：佛山市卫生项目(20200359)。

摘　　要：目的:探讨注射用白眉蛇毒血凝酶引起出血患者纤维蛋白原减少的相关因素。方法:选取2020年1月—12月在我院住院期间使用注射用白眉蛇毒血凝酶患者100例,通过病历系统收集与整理患者的一般情况(年龄、性别),用药情况(使用总剂量、合并使用其他止血药物的情况)和生化指标数据(血常规、肝功能、肾功能、凝血功能),采用单因素和二项Logistic回归分析发生低纤维蛋白原的相关因素,并用工作特征曲线(ROC曲线)筛选预测发生低纤维蛋白原敏感度和特异度均较好时的因素切点值。结果:本次调查的100例患者中,有29例(29%)发生纤维蛋白原减少,71例纤维蛋白原正常。低纤维蛋白原组男性的比例、用药剂量和合并用药的比例较纤维蛋白原正常组高,差异有统计学意义(P<0.05)。低纤维蛋白原组患者用药前的ALB、TP、PLT、FIB四项指标较纤维蛋白原正常组低,而凝血功能指标中INR、PT两项指标较纤维蛋白原正常组高,差异具有统计学意义(P<0.05)。二项Logistic回归分析显示白眉蛇毒血凝酶使用总剂量、血小板计数、谷草转氨酶(AST)、纤维蛋白原水平是引发低纤维蛋白原的相关危险因素,其相关危险因素比值比分别为1.794、0.982、1.230、0.04;ROC曲线结果显示,与注射用白眉蛇毒剂量相关的低纤维蛋白原的曲线下面积0.636,敏感度为41.38%,特异度为87.3%,切点所示白眉蛇毒血凝酶剂量为5KU。结论:注射用白眉蛇毒血凝酶使用总剂量≥5KU、用药前血小板计数、纤维蛋白原水平较低的患者,发生纤维蛋白原减少的可能性越大,需要加强纤维蛋白原水平的监测,警惕患者在用药过程中发生出血的情况。Objective To investigate the related factors of fibrinogen reduction in patients with hemorrhage caused by hemoglobinase from baimeei venom for injection.Methods A total of 100 patients who were admitted to our hospital from January to December 2020 and used hemagglutinin for injection were selected.A retrospective investigation was used to systematically collect and sort out the general conditions(age and gender)of the patients through medical records.Drug use(total dose and combined use of other hemostatic drugs)and biochemical index data(blood routine,liver function,renal function,coagulation function),univariate and binomial Logistic regression were used to analyze the correlation between these factors and the occurrence of low fibrinogen.The cut-off point values of low fibrinogen sensitivity and specificity were screened and predicted by receiver operating characteristic curve(ROC).Results A total of 100 cases were investigated,of which 29(29%)had fibrinogen reduction.71 case with normal fibrinogen.The proportion of men,drug dose and the proportion of combined drugs in the low fibrinogen group were hgiher than those in the normal fibrinogen group,with statistica lsignificance(P<0.05).Before medication,ALB,TP,PLT and FIB were lower in the low fibrinogen group than in the normal fibrinogen group,while INR and PT were higher in the coagulation function index than in the normal fibrinogen group,with statistical significance(P<0.05).Binomial Logistic regression analysis showed that the total dose of hemagglutinin,platelet count,AST and fibrinogen level were the related risk factors for low fibrinogen,and the associated risk factor ratios were 1.794,0.982,1.230 and 0.04,respectively.ROC curve results showed that the area under the curve of low fibrinogen was 0.636,the sensitivity was 41.38%,and the specificity was 87.3%.The cut-off point showed that the hemagglutinin dose was 5 KU.Conclusions Patients with total dose≥5 KU of hemagglutinin for injection and low platelet count and fibrinogen level before administr

关 键 词：白眉蛇毒血凝酶 低纤维蛋白原 相关因素分析 

分 类 号：R442.7[医药卫生—诊断学]