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纤维蛋白降解产物/纤维蛋白原比值反映了钝性创伤患者对浓缩红细胞输血的需求。

FDP/fibrinogen ratio reflects the requirement of packed red blood cell transfusion in patients with blunt trauma.

作者信息

Hagiwara Shuichi, Aoki Makoto, Murata Masato, Kaneko Minoru, Ichikawa Yumi, Nakajima Jun, Isshiki Yuta, Sawada Yusuke, Tamura Jun'ichi, Oshima Kiyohiro

机构信息

Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.

Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.

出版信息

Am J Emerg Med. 2017 Aug;35(8):1106-1110. doi: 10.1016/j.ajem.2017.03.009. Epub 2017 Mar 7.

Abstract

PURPOSE

To find factors that predict the requirement of packed red blood cells (pRBC) transfusion in patients with blunt trauma on arrival at the hospital.

METHODS

We conducted blood tests in trauma patients whose trauma severity was suspected as being 3 and over in the Abbreviated Injury Scale. Patients were divided into the blood transfusion (BT) and control groups according to the requirement of pRBC transfusion within 24h after arrival.

RESULTS

We analyzed 347 patients (BT group, n=14; control group, n=333). On univariate analysis, there were significant differences in Glasgow Coma Scale (GCS), rate of positive FAST (focused assessment with sonography for trauma) finding, hematocrit, international normalized ratio of prothrombin time, activated partial thromboplastin time, fibrinogen (Fib), and level of fibrin degradation products (FDP). On multivariable analysis, positive FAST finding, GCS, Fib, and FDP influenced the requirement of pRBC transfusion. In the area under the receiver operating characteristic curve analysis, Fib and FDP were markers that predicted the requirement of pRBC transfusion. The FDP/Fib ratio had a better correlation with the requirement of pRBC transfusion than FDP or Fib.

CONCLUSIONS

The FDP/Fib ratio can be easily measured and may be a predictor of the need for pRBC transfusion.

摘要

目的

寻找预测钝性创伤患者入院时红细胞悬液(pRBC)输血需求的因素。

方法

我们对简略损伤量表中创伤严重程度疑似为3级及以上的创伤患者进行了血液检测。根据患者入院后24小时内pRBC输血需求将其分为输血(BT)组和对照组。

结果

我们分析了347例患者(BT组,n = 14;对照组,n = 333)。单因素分析显示,格拉斯哥昏迷量表(GCS)、创伤重点超声评估(FAST)阳性率、血细胞比容、凝血酶原时间国际标准化比值、活化部分凝血活酶时间、纤维蛋白原(Fib)及纤维蛋白降解产物(FDP)水平存在显著差异。多因素分析显示,FAST阳性、GCS、Fib及FDP影响pRBC输血需求。在受试者工作特征曲线分析中,Fib和FDP是预测pRBC输血需求的指标。FDP/Fib比值与pRBC输血需求的相关性优于FDP或Fib。

结论

FDP/Fib比值易于测定,可能是pRBC输血需求的预测指标。

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