创伤性凝血病患者外周APC、vWF、D-D水平变化与凝血功能及预后的相关性分析  

Correlation analysis of APC,vWF,D-D with coagulation function and prognosis in patients with trauma-induced coagulopathy

作　　者：杨秋林[1] 吴锋[1] 吴彬彬 张小文 吴湘军 YANG Qiulin;WU Feng;WU Binbin(Department of Intensive Care Unit,Zhejiang Quhua Hospital,Quzhou 324000,China)

机构地区：[1]浙江衢化医院ICU,浙江衢州324000

出　　处：《全科医学临床与教育》2022年第1期18-21,共4页Clinical Education of General Practice

摘　　要：目的研究创伤性凝血病(TIC)患者外周活化蛋白C(APC)、血管性假血友病因子(vWF)、D-二聚体(D-D)水平变化与凝血功能及预后的相关性。方法选取92例TIC患者作观察组,另选取同时期入院无创伤者92例作为对照组,比较两组的APC、vWF及D-D水平以及活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)等指标变化。Pearson相关性分析APC、vWF、D-D与凝血功能相关关系;logistic分析TIC加重的影响因子,生存分析TIC患者的预后状况。结果观察组患者的APC、vWF、D-D水平、PT、APTT、INR均高于对照组,差异均有统计学意义(t分别=19.57、20.83、41.26、50.16、40.08、25.87,P均<0.05)。Pearson相关性分析显示,TIC患者APC与TT、APTT、INR呈正相关(r分别=0.75、0.69、0.64,P均<0.05),vWF与TT、APTT、INR呈正相关(r分别=0.82、0.77、0.76,P均<0.05);D-D与TT、APTT、INR呈正相关(r分别=0.93、0.90、0.84,P均<0.05);logistic分析显示,APC、vWF、D-D是TIC加重的影响因素(OR分别=0.25、0.95、0.96,P均<0.05)。TIC患者的2年生存率为90.22%。结论APC、vWF、D-D与TIC患者预后的凝血功能有着相关性,可作为临床TIC患者检测、监护的指标,对患者病情加重的预测具有参考意义。Objective To study the relationship between the levels of peripheral activated protein C(APC),von willebrand factor(vWF),D-dimer(D-D)and coagulation function and prognosis in patients with trauma-induced coagulopathy(TIC). Methods A total of 92 patients with TIC were selected as the observation group and 92 patients without trauma were selected as the control group. The changes of APC,vWF,D-D,activated partial thromboplastin time(APTT),prothrombin time(PT)and international standard ratio(INR)were compared between two groups.The APC,vWF,D-D and coagulation function were analyzed by pearson correlation analysis,the influencing factors of TIC exacerbation were analyzed by logistic analysis,and the prognosis of TIC patients was analyzed by survival analysis. Results The levels of APC,vWF,D-D,PT,APTT,INR in the observation group were significantly higher than those in the control group(t=19.57,20.83,41.26,50.16,40.08,25.87,P<0.05).Pearson correlation analysis showed that APC was positively correlated with TT,APTT,and INR(r=0.75,0.69,0.64,P<0.05),vWF was positively correlated with TT,APTT,and INR(r=0.82,0.77,0.76,P<0.05),D-D was positively correlated with TT,APTT,and INR(r=0.93,0.90,0.84,P<0.05),and logistic analysis showed that APC,vWF,and D-D were the influencing factors of TIC aggravation(OR=0.25,0.95,0.96,P<0.05).The 2-year survival rate of TIC patients was 90.22%. Conclusion There is correlation between APC,vWF and D-D and the prognosis of patients with TIC,which can be used as the indexes of clinical monitoring and monitoring of patients with TIC.

关 键 词：创伤性凝血病 D-二聚体 血管性假血友病因子 活化蛋白C 凝血功能 预后 

分 类 号：R641[医药卫生—外科学]