动态监测血浆D-D、PT、APTT、TT、FIB、FDP对消化性溃疡出血患者再出血预测价值  

The Predictive Value of Dynamic Monitoring of Plasma D-D,PT,APTT,TT,FIB,and FDP for Rebleeding in Patients with Peptic Ulcer Bleeding

作　　者：汤金光 TANG Jinguang(Department of Clinical Laboratory,the First Hospital of Tongxu,Kaifeng Henan 475400,China)

机构地区：[1]通许第一医院检验科,河南开封475400

出　　处：《临床研究》2023年第10期127-130,共4页Clinical Research

摘　　要：目的探讨动态监测血浆D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)对消化性溃疡出血(PUB)患者再出血预测价值。方法选取通许第一医院2020年1月至2022年10月收治的173例PUB患者为研究对象,根据治疗后30 d是否发生再出血将患者分为再出血组(35例)和未再出血组(138例)。比较两组血浆D-D、PT、APTT、TT、FIB、FDP水平,分析血浆各指标水平与再出血相关性,偏回归分析再出血的影响因素;分析各指标水平联合检测对PUB患者发生再出血的AUC、最佳诊断敏感度、特异度。结果再出血组高于未再出血组血浆D-D、PT、APTT、TT、FDP水平,FIB水平低于未再出血组,差异有统计学意义(P<0.05)。治疗后7 d、治疗后14 d血浆D-D、PT、APTT、TT、FDP与再出血均呈正相关,是治疗后30 d发生再出血的危险因素,血浆FIB与再出血呈负相关,是发生再出血的保护因素,差异有统计学意义(P<0.05)。治疗后7 d、治疗后14 d血浆各指标水平联合预测发生再出血的AUC为0.756、0.806,最佳诊断敏感度88.57%、94.29%、特异度分别为62.32%、66.67%。结论血浆D-D、PT、APTT、TT、FBG、FDP水平与PUB病情严重程度关系密切,对临床病情判断及预后评估有重要意义。Objective To investigate the predictive value of dynamic monitoring of plasma D-dimer(D-D),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and fibrinogen degradation products(FDP)for rebleeding in patients with peptic ulcer bleeding(PUB).Methods A total of 173 PUB patients admitted to the First Hospital of Tongxu from January 2020 to October 2022 were selected as the research objects.According to whether rebleeding occurred 30 days after treatment,the patients were divided into a rebleeding group(35 cases)and a non-rebleeding group(138 cases).The plasma levels of D-D,PT,APTT,TT,FIB,and FDP were compared between the two groups.The correlation between the levels of plasma indexes and rebleeding was analyzed,and the influencing factors of rebleeding were analyzed by partial regression.To analyze the AUC,the best diagnostic sensitivity and specificity of the combined detection of each index level on the occurrence of rebleeding in PUB patients.Results The plasma levels of D-D,PT,APTT,TT,and FDP in the rebleeding group were higher than those in the non-rebleeding group,and the FIB level was lower than those in the nonrebleeding group,the difference was statistically significant(P<0.05).Plasma D-D,PT,APTT,TT,and FDP were positively correlated with rebleeding at 7 and 14 days after treatment and were risk factors for rebleeding at 30 days after treatment.Plasma FIB was negatively correlated with rebleeding,and was a protective factor for rebleeding,with statistical significance(P<0.05).The AUC of the combination of plasma index levels at 7 days and 14 days after treatment for predicting rebleeding was 0.756 and 0.806,and the best diagnostic sensitivity was 88.57%,94.29%,and specificity was 62.32%and 66.67%,respectively.Conclusion The levels of plasma D-D,PT,APTT,TT,FBG,and FDP are closely related to the severity of PUB and have important significance for clinical condition judgment and prognosis evaluation.

关 键 词：消化性溃疡出血 再出血 PT D-D APTT TT FIB FDP 

分 类 号：R446.1[医药卫生—诊断学]