Kochi Masatoshi, Shimomura Manabu, Hinoi Takao, Egi Hiroyuki, Tanabe Kazuaki, Ishizaki Yasuyo, Adachi Tomohiro, Tashiro Hirotaka, Ohdan Hideki
Masatoshi Kochi, Hiroyuki Egi, Kazuaki Tanabe, Tomohiro Adachi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima city, Hiroshima 734-8551, Japan.
World J Gastroenterol. 2017 Mar 28;23(12):2209-2216. doi: 10.3748/wjg.v23.i12.2209.
To examine the role of soluble fibrin monomer complex (SFMC) in the prediction of hypercoagulable state after gastroenterological surgery.
We collected data on the clinical risk factors and fibrin-related makers from patients who underwent gastroenterological surgery at Hiroshima University Hospital between April 1, 2014 and March 31, 2015. We investigated the clinical significance of SFMC, which is known to reflect the early plasmatic activation of coagulation, in the view of these fibrin related markers.
A total of 123 patients were included in the present study. There were no patients with symptomatic VTE. Thirty-five (28%) patients received postoperative anticoagulant therapy. In the multivariate analysis, a high SFMC level on POD 1 was independently associated with D-dimer elevation on POD 7 (OR = 4.31, 95%CI: 1.10-18.30, = 0.03). The cutoff SFMC level was 3.8 μg/mL (AUC = 0.78, sensitivity, 63%, specificity, 89%). The D-dimer level on POD 7 was significantly reduced in high-SFMC patients who received anticoagulant therapy in comparison to high-SFMC patients who did not.
The SFMC on POD 1 strongly predicted the hypercoagulable state after gastroenterological surgery than the clinical risk factors and the other fibrin related markers.
探讨可溶性纤维蛋白单体复合物（SFMC）在预测胃肠外科手术后高凝状态中的作用。
我们收集了2014年4月1日至2015年3月31日在广岛大学医院接受胃肠外科手术患者的临床危险因素和纤维蛋白相关标志物的数据。鉴于这些纤维蛋白相关标志物，我们研究了已知能反映凝血早期血浆激活的SFMC的临床意义。
本研究共纳入123例患者。无有症状的静脉血栓栓塞患者。35例（28%）患者接受了术后抗凝治疗。在多变量分析中，术后第1天SFMC水平高与术后第7天D - 二聚体升高独立相关（OR = 4.31，95%CI：1.10 - 18.30，P = 0.03）。SFMC的截断水平为3.8μg/mL（AUC = 0.78，敏感性63%，特异性89%）。与未接受抗凝治疗的高SFMC患者相比，接受抗凝治疗的高SFMC患者术后第7天的D - 二聚体水平显著降低。
术后第1天的SFMC比临床危险因素和其他纤维蛋白相关标志物更能强烈预测胃肠外科手术后的高凝状态。
