重型颅脑创伤后高凝血状态与抗心磷脂抗体和抗凝血酶Ⅲ水平异常的关系  

Relationship between hypercoagulable state and abnormal levels of anti-cardiolipin antibody and anti-thrombin Ⅲ after severe traumatic brain injury

作　　者：赵卫平 邢栋 杨文博 孙鹏 杨蔚然 苏宁 王忠 韩志桐 张瑞剑 Zhao Weiping;Xing Dong;Yang WenBo;Sun Peng;Yang Weiran;Su Ning;Wang Zhong;Han Zhitong;Zhang Ruijian(Department of Neurosurgery,Inner Mongolia People′s Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古自治区人民医院神经外科,呼和浩特010017

出　　处：《中华实验外科杂志》2021年第12期2508-2511,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨重型颅脑创伤后高凝血状态与抗心磷脂抗体和抗凝血酶Ⅲ水平异常的关系。方法分析内蒙古自治区人民医院2018年4月至2020年7月收治的79例重型颅脑创伤患者的临床资料,按照是否合并高凝血状态分为高凝血状态组(35例)与无高凝血状态组(44例)。另选取同期在内蒙古自治区人民医院进行体检的40例健康者作为对照组。比较各组的抗心磷脂抗体、抗凝血酶Ⅲ水平以及凝血指标]包括D-二聚体、纤维蛋白降解产物(FDP)、凝血酶原时间(PT)],并对抗心磷脂抗体、抗凝血酶Ⅲ水平与凝血指标的相关性进行分析。结果3组的抗心磷脂抗体、抗凝血酶Ⅲ水平比较,差异有统计学意义(Z=55.793,F=21.629,P<0.05)。高凝血状态组的抗心磷脂抗体阳性率高于无高凝血状态组、对照组,抗凝血酶Ⅲ水平低于无高凝血状态组组[(238.34±7.65)mg/L比(271.69±13.51)mg/L]、对照组[(238.34±7.65)mg/L比(315.38±31.06)mg/L],差异有统计学意义(Z=15.141、44.676,F=14.483、26.738,P<0.05)无高凝血状态组的抗心磷脂抗体阳性率高于对照组,抗凝血酶Ⅲ水平低于对照组,差异有统计学意义(Z=19.182、17.159,P<0.05)。3组的D-二聚体、FDP、PT比较,差异有统计学意义(F=67.319、11.394、27.382,P<0.05)。高凝血状态组的D-二聚体、FDP水平高于无高凝血状态组[(3.05±0.17)μg/ml比(0.53±0.11)μg/ml、(12.42±2.11)mg/L比(8.01±1.13)mg/L]、对照组[(3.05±0.17)μg/ml比(0.24±0.07)μg/ml、(12.42±2.11)mg/L比(3.47±0.35)mg/L],PT短于无高凝血状态组[(5.04±0.37)s比(10.99±1.15)s]、对照组[(5.04±0.37)s比(12.82±2.06)s],差异有统计学意义(t高凝血状态组比无高凝血状态组=62.128、8.237、21.506,t高凝血状态组比对照组=69.415、13.185、30.823,P<0.05)。无高凝血状态组的D-二聚体、FDP水平高于对照组,PT短于对照组,差异有统计学意义(t=5.251、7.036、13.508,P<0.05)。Pearson相关分析显示,抗心磷脂抗体与D-二聚�Objective To investigate the relationship between between hypercoagulable state and abnormal levels of anti-cardiolipin antibody and anti-thrombinⅢafter severe traumatic brain injury.Methods The clinical data of 79 patients with severe traumatic brain injury admitted to our hospital from April 2018 to July 2020 were analyzed,they were divided into the hypercoagulability state group(35 cases)and the non-hypercoagulable state group(44 cases)according to whether they were combined with hypercoagulable state.Another 40 cases of healthy people who had physical examination in our hospital at the same time were selected as the control group.The levels of anti-cardiolipin antibody,anti-thrombinⅢand coagulation indexes[including D-dimer,fibrin degradation product(FDP),prothrombin time(PT)]were compared in each group,and the correlation between anti-cardiolipin antibody,anti-thrombinⅢlevel and coagulation index was analyzed.The levels of anti-cardiolipin antibodies,anti-thrombinⅢand coagulation parameters(including D-dimer,FDP,PT)were compared among the groups,and the correlation between anti-cardiolipin antibody,anti-thrombinⅢlevel and coagulation index was analyzed.Results There were significantly difference in the levels of anti-cardiolipin antibody and anti-thrombinⅢbetween the three groups(Z=55.793,F=21.629,P<0.05).The positive rate of anti-cardiolipin antibody in the hypercoagulable state group was higher than that in the non-hypercoagulable state group and the control group,and anti-thrombinⅢlevel in the hypercoagulable state group was lower than that in the non-hypercoagulable state group[(238.34±7.65)mg/L vs.(271.69±13.51)mg/L]and the control group[(238.34±7.65)mg/L vs.(315.38±31.06)mg/L],and the differences were statistically significant(Z=15.141,44.676,F=14.483,26.738,P<0.05).The positive rate of anti-cardiolipin antibody in the non-hypercoagulable state group was higher than that in the control group,and anti-thrombinⅢlevel in the non-hypercoagulable state group was lower than that in the co

关 键 词：抗心磷脂抗体 抗凝血酶Ⅲ 重型颅脑创伤 高凝血状态 

分 类 号：R651.15[医药卫生—外科学]