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克里米亚-刚果出血热患者的凝血功能参数及其与死亡率的关系。

Coagulopathy parameters in patients with Crimean-Congo hemorrhagic fever and its relation with mortality.

机构信息

Department of Infectious Diseases and Clinical Microbiology, Numune Education and Research Hospital, Ankara, Turkey.

出版信息

J Clin Lab Anal. 2010;24(3):163-6. doi: 10.1002/jcla.20383.

Abstract

BACKGROUND

Crimean-Congo hemorrhagic fever (CCHF) is an acute illness affecting multiple organ systems and characterized by ecchymosis, visceral bleeding, and hepatic dysfunction. In this study, we aimed to investigate the profile of coagulopathy markers (platelet count, activated partial tromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), fibrinogen, protein C, protein S, antithrombin III, activated protein C resistance (APCR), and D-dimer) and their clinical significance in 83 CCHF-infected patients.

SUBJECTS AND METHODS

We studied 83 CCHF patients who were admitted to Ankara Numune Education and Research Hospital during the spring and summer of2007. We compared the coagulopathy markers of fatal CCHF patients (n=9) with nonfatal cases (n=74).

RESULTS

Platelet count, PT, aPTT, INR, and fibrinogen were prognostic factors associated with mortality for CCHF. Especially, platelet count<20 x 10(9) cells/l and aPTT>60 sec were important. Protein C, protein S, APCR, and antithrombin III levels were not associated with mortality.

CONCLUSION

Laboratory tests including classical parameters (platelet count, PT, aPTT, INR, and fibrinogen) of coagulopathy seem to be enough for the followup of CCHF. Protein S, protein C, APCR, and D-dimer levels were not associated with mortality.

摘要

背景

克里米亚-刚果出血热(CCHF)是一种影响多个器官系统的急性疾病,其特征为瘀点、内脏出血和肝功能障碍。在本研究中,我们旨在研究凝血功能障碍标志物(血小板计数、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)、纤维蛋白原、蛋白 C、蛋白 S、抗凝血酶 III、活化蛋白 C 抵抗(APCR)和 D-二聚体)及其在 83 例 CCHF 感染患者中的临床意义。

受试者和方法

我们研究了 2007 年春季和夏季期间在安卡拉 Numune 教育和研究医院就诊的 83 例 CCHF 患者。我们比较了致命性 CCHF 患者(n=9)和非致命性病例(n=74)的凝血功能障碍标志物。

结果

血小板计数、PT、aPTT、INR 和纤维蛋白原是与 CCHF 死亡率相关的预后因素。特别是血小板计数<20 x 10(9) 细胞/l 和 aPTT>60 秒是重要的因素。蛋白 C、蛋白 S、APCR 和抗凝血酶 III 水平与死亡率无关。

结论

包括凝血功能障碍的经典参数(血小板计数、PT、aPTT、INR 和纤维蛋白原)在内的实验室检查似乎足以用于 CCHF 的随访。蛋白 S、蛋白 C、APCR 和 D-二聚体水平与死亡率无关。

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