凝血功能与原发性闭角型青光眼患者的相关性：一项 5 年回顾性病例对照研究。
Association between coagulation function and patients with primary angle closure glaucoma: a 5-year retrospective case-control study.
机构信息
Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
出版信息
BMJ Open. 2017 Nov 4;7(11):e016719. doi: 10.1136/bmjopen-2017-016719.
OBJECTIVE
To evaluate the association between coagulation function and patients with primary angle closure glaucoma (PACG).
DESIGN
A retrospective, hospital-based, case-control study.
SETTING
Shanghai, China.
PARTICIPANTS
A total of 1778 subjects were recruited from the Eye & ENT Hospital of Fudan University from January 2010 to December 2015, including patients with PACG (male=296; female=569) and control subjects (male=290; female=623).
OUTCOME MEASURES
Sociodemographic data and clinical data were collected. The one-way analysis of variance test was used to compare the levels of laboratory parameters among the mild, moderate and severe PACG groups. Multivariate logistic regression analyses were performed to identify the independent risk factors for PACG. The nomogram was constructed based on the logistic regression model using the R project for statistical computing (R V.3.3.2).
RESULTS
The activated partial thromboplastin time (APTT) of the PACG group was approximately 4% shorter (p<0.001) than that of the control group. The prothrombin time (PT) was approximately 2.40% shorter (p<0.001) in patients with PACG compared with the control group. The thrombin time was also approximately 2.14% shorter (p<0.001) in patients with PACG compared with the control group. The level of D-dimer was significantly higher (p=0.042) in patients with PACG. Moreover, the mean platelet volume (MPV) of the PACG group was significantly higher (p=0.013) than that of the control group. A similar trend was observed when coagulation parameters were compared between the PACG and control groups with respect to gender and/or age. Multiple logistic regression analyses revealed that APTT (OR=1.032, 95% CI 1.000 to 1.026), PT (OR=1.249, 95% CI 1.071 to 1.457) and MPV (OR=1.185, 95% CI 1.081 to 1.299) were independently associated with PACG.
CONCLUSION
Patients with PACG had a shorter coagulation time. Our results suggest that coagulation function is significantly associated with patients with PACG and may play an important role in the onset and development of PACG.
目的
评估凝血功能与原发性闭角型青光眼（PACG）患者之间的关系。
设计
回顾性、基于医院的病例对照研究。
地点
中国上海。
参与者
本研究共纳入 1778 名受试者，均来自复旦大学附属眼耳鼻喉科医院，于 2010 年 1 月至 2015 年 12 月期间进行招募，包括 PACG 患者（男性 296 例，女性 569 例）和对照组受试者（男性 290 例，女性 623 例）。
观察指标
收集受试者的人口统计学数据和临床数据。采用单因素方差分析比较轻度、中度和重度 PACG 组之间实验室参数的水平。采用多元逻辑回归分析确定 PACG 的独立危险因素。使用 R 项目进行统计计算（R V.3.3.2）基于逻辑回归模型构建列线图。
结果
PACG 组的活化部分凝血活酶时间（APTT）比对照组缩短约 4%（p<0.001）。PACG 患者的凝血酶原时间（PT）比对照组缩短约 2.40%（p<0.001）。PACG 患者的凝血酶时间也比对照组缩短约 2.14%（p<0.001）。PACG 患者的 D-二聚体水平显著升高（p=0.042）。此外，PACG 组的平均血小板体积（MPV）明显高于对照组（p=0.013）。在 PACG 组和对照组中，性别和/或年龄对凝血参数的影响也存在类似的趋势。多因素逻辑回归分析显示，APTT（OR=1.032，95%CI 1.000 至 1.026）、PT（OR=1.249，95%CI 1.071 至 1.457）和 MPV（OR=1.185，95%CI 1.081 至 1.299）与 PACG 独立相关。
结论
PACG 患者的凝血时间较短。我们的结果表明，凝血功能与 PACG 患者显著相关，可能在 PACG 的发病和发展中起重要作用。
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