竹叶青咬伤患者综合治疗下凝血因子动态变化的真实世界研究  

Real world study on dynamic changes of coagulation factors in patients with bamboo leaf green bite under comprehensive treatment

作　　者：卓振权 李奕鑫 张晓萍 罗毅[2] ZHUO Zhenquan;LI Yixin;ZHANG Xiaoping;LUO Yi(Department of Emergency,910th Hospital of Joint Logistics Support Force,Quanzhou,Fujian 362000,China;Department of Emergency,Liuzhou Hospital of Traditional Chinese Medicine,Liuzhou,Guangxi 545001,China)

机构地区：[1]联勤保障部队第910医院急诊科,福建泉州362000 [2]柳州市中医院急诊科,广西柳州545001

出　　处：《国际检验医学杂志》2023年第11期1340-1342,1347,共4页International Journal of Laboratory Medicine

基　　金：广西壮族自治区卫生健康委青年基金项目(Z20200021)。

摘　　要：目的基于真实世界研究分析竹叶青咬伤患者综合治疗下凝血因子的动态变化。方法选取2019年5月至2021年8月于联勤保障部队第910医院就诊的53例竹叶青咬伤患者为研究对象,检测患者在竹叶青咬伤后第1、3、5天内源性凝血因子(FⅧ、FⅨ、FⅪ、FⅫ)和外源性凝血因子(FⅡ、FⅤ、FⅦ、FⅩ)及D-二聚体水平。结果FⅧ、FⅨ和FⅪ水平均表现为第3天达到高峰、第5天回落的趋势;FⅧ水平在第1、3、5天升高的比例分别为62.26%、71.70%、56.60%;FⅨ水平在第1、3、5天升高的比例分别为35.85%、58.49%、49.06%;FⅪ水平在第1、3、5天升高的比例分别为20.75%、30.19%、24.53%;D-二聚体水平在第1、3、5天升高的比例分别为77.36%、96.23%、92.45%;FⅫ、FⅡ、FⅤ、FⅦ、FⅩ水平在各时间点均无明显变化。结论竹叶青咬伤后可导致促凝系统活跃,部分患者内源性凝血因子水平升高,而对外源性凝血途径影响较小;患者纤溶亢进、D-二聚体水平升高对早期诊断敏感性较高。Objective To analyze the dynamic changes of blood coagulation factors in patients with bamboo leaf green bite under comprehensive treatment based on real world study.Methods A total of 53 patients with snakebite admitted to the 910th Hospital of Joint Logistics Support Force from May 2019 to August 2021 were selected as the research subjects.The levels of endogenous coagulation factors(FⅧ,FⅨ,FⅪ,FⅫ),exogenous coagulation factors(FⅡ,FⅤ,FⅦ,FⅩ)and D-dimer were detected on the 1st,3rd and 5th day after bamboo leaf green bite.Results The levels of FⅧ,FⅨand FⅪreached the peak on the 3rd day and then decreased on the 5th day.The proportion of increased FⅧlevels on day 1,3 and 5 were 62.26%,71.70%and 56.60%,respectively.The proportion of increased FⅨlevels on day 1,3 and 5 were 35.85%,58.49%and 49.06%,respectively.The proportion of increased FⅪlevels on day 1,3,and 5 were 20.75%,30.19%,and 24.53%,respectively.D-dimer levels increased in 77.36%,96.23%,and 92.45%of the patients on the 1st,3rd,and 5th day,respectively.There was no significant change in FⅫ,FⅡ,FⅤ,FⅦand FⅩlevels at each time point.Conclusion The procoagulant system is active after the bite of bamboo leaf green,and the levels of endogenous coagulation factors are increased in some patients,but the effect on exogenous coagulation pathway is small.Patients with hyperfibrinolysis and elevated D-dimer levels have high sensitivity for early diagnosis.

关 键 词：竹叶青 综合治疗 凝血因子 动态变化 真实世界研究 

分 类 号：R646[医药卫生—外科学]