本文關(guān)鍵詞： 急性創(chuàng)傷性凝血病 活化蛋白C 血管性假血友病因子 D二聚體　出處：《山東醫(yī)藥》2017年34期 　論文類型：期刊論文

【摘要】：目的觀察急性創(chuàng)傷性凝血病(ATC)不同預后患者外周血活化蛋白C(APC)、血管性假血友病因子(vWF)、D二聚體(D-D)水平變化,并探討其臨床意義。方法選取ATC患者119例,根據(jù)患者預后不同分為存活組89例、死亡組30例;取兩組入院24 h內(nèi)外周血,酶聯(lián)免疫吸附法檢測血清APC,采用電化學發(fā)光檢測血漿vWF、D-D;收集患者資料,采用Logistic回歸分析ATC患者預后的危險因素。結(jié)果存活組入院24 h血清APC為(3.15±1.22)ng/m L、血漿vWF為178.9%±36.3%、血漿D-D為(186.4±39.0)ng/m L;死亡組血清APC為(3.98±1.40)ng/m L、血漿vWF為228.4%±48.7%、血漿D-D為(214.9±32.8)ng/m L,兩組比較差異均有統(tǒng)計學意義(P均0.05)。Logistic回歸分析顯示,外周血APC(OR=1.492,95%CI 1.313~4.604,P=0.045)、vWF(OR=1.387,95%CI 1.195~3.851,P=0.035)、D-D(OR=1.525,95%CI 1.264~5.175,P=0.043)水平升高是ATC患者預后不良的獨立危險因素(P均0.05)。結(jié)論 ATC不良預后患者外周血APC、vWF、D-D水平顯著升高,檢測三者水平有利于ATC患者的預后判斷。
[Abstract]:Objective to observe the changes of peripheral blood activating protein (APC) and von Willebrand factor (vWF) D dimer (D-D) in patients with acute traumatic thromboplasmosis (ATC) with different prognosis. Methods 119 patients with ATC were divided into survival group (89 cases) and death group (30 cases) according to their prognosis. The serum APCs were detected by enzyme-linked immunosorbent assay (Elisa) and the plasma vWFT-D was detected by electrochemiluminescence (ECL). The data of patients were collected and the prognostic factors of ATC patients were analyzed by Logistic regression analysis. Results the serum APC in survival group was 3.15 鹵1.22 ng / mL at 24 h after admission. Plasma vWF was 178.9% 鹵36.3%, plasma D-D was 186.4 鹵39.0 ng / mL; In the dead group, the serum APC was 3.98 鹵1.40 ng / mL, and the plasma vWF was 228.4% 鹵48.7%. The plasma D-D was 214.9 鹵32.8 ng / mL, and the difference between the two groups was statistically significant (P < 0.05). Logistic regression analysis showed that there was no significant difference between the two groups. The peripheral blood APC ORA was 1.492c95, CI 1.31344.604, P0. 045 / vWFN 1.387. 95 CI 1.195 / 3.851C / P 0.035 / D / D OR1.52595 / CI 1.264 / 5.175. Conclusion the elevated level of ATC is an independent risk factor for poor prognosis in patients with ATC. Conclusion\\\ conclusion\\\;\\\; The level of D-D was significantly increased, and detection of the three levels was beneficial to the prognosis of patients with ATC.
【作者單位】： 石家莊市第三醫(yī)院;
【基金】：河北省石家莊市科學技術(shù)研究與發(fā)展指導計劃立項(164629)
【分類號】：R641
【正文快照】： 急性創(chuàng)傷性凝血病(ATC)是臨床上較常見的外傷性疾病,在車禍、斗毆等強力外傷的作用下,機體應激功能障礙,從而引起凝血功能、纖維蛋白溶解系統(tǒng)及抗纖溶系統(tǒng)的紊亂,加劇了凝血功能異常導致的出血性疾病、休克等的發(fā)生[1,2]�；罨鞍證(APC)、血管性假血友病因子(v WF)、D二聚體(

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