Department of Anesthesia, Hospital Clínic, Agustí Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain -
Department of Hemostasis, Hospital Clínic, Agustí Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
Minerva Anestesiol. 2018 Jul;84(7):848-857. doi: 10.23736/S0375-9393.17.12313-8. Epub 2017 Dec 13.
The longstanding dogma that patients with liver disease have a hemostasis related bleeding tendency is neglected from the last 10 years however, despite this tremendous change of paradigm no longer progress had been made in this field. A mathematical model is a description of a system using mathematical concepts and language. Mathematical models are able to analyze large amount of data and they can make predictions about behavior. Mathematical models are used in the social sciences, engineering as well as in medicine. Blood coagulation in patients with liver disease is difficult to predict due to its network complexity and moreover, due to all factors that potentially can impact hemostasis in this patient population outside of the coagulation itself, as portal hypertension, endothelial dysfunction and renal injury, between others. Although ambitious and extremely complex, the aforementioned approach requires a substantial investment of multidisciplinary human and technologic resources, this holistic overview is the closest to the real situation. The ability of the mathematical modeling to predict bleeding and thrombotic complications in patients with liver disease deserves to be investigated.
然而，尽管这种观念已经发生了巨大的转变，但过去 10 年来，人们一直忽视了肝脏疾病患者存在与止血相关的出血倾向这一长期存在的教条。数学模型是使用数学概念和语言对系统进行描述的一种方法。数学模型能够分析大量数据，并对行为进行预测。数学模型被广泛应用于社会科学、工程学以及医学领域。由于网络的复杂性，以及除了凝血本身之外，所有可能影响该患者群体止血的潜在因素，如门静脉高压、内皮功能障碍和肾损伤等，肝脏疾病患者的凝血情况难以预测。尽管这种方法雄心勃勃且极其复杂，但需要投入大量多学科的人力和技术资源，这种整体的观点是最接近实际情况的。数学模型预测肝脏疾病患者出血和血栓并发症的能力值得进一步研究。
