Li Shuwen, Lu Jiakai, Cheng Weiping, Zhu Junming, Jin Mu
Department of Anaesthesiology, Beijing AnZhen Hospital, Capital Medical University, Beijing, China.
Department of Cardiology surgery, Beijing AnZhen Hospital, Capital Medical University, Beijing, China.
Ann Thorac Cardiovasc Surg. 2019 Jun 20;25(3):142-148. doi: 10.5761/atcs.oa.18-00187. Epub 2018 Dec 18.
Platelets are crucial components of the coagulation processes, and low admission platelet count (PLC) is associated with adverse clinical outcomes in patients with Stanford type A acute aortic dissection (AAD).
A total of 130 consecutive patients undergoing Stanford type A AAD surgery in Beijing Anzhen Hospital were enrolled between January 2013 and July 2014. Preoperative clinical and laboratory data from patients were collected. Multiple regression analyses were used to determine the independent factors of low admission platelets.
Adjusted multiple regression analysis showed that age (β: -1.069, 95% confidence interval [CI]: -2.109, -0.029), sex (β: -29.973, 95% CI: -56.512, -3.433), tissue factor pathway inhibitor (TFPI; β: 0.197, 95% CI: 0.039, 0.354), fibrinogen degradation product (FDP) (β: -0.476, 95% CI: -0.879, -0.074), and attack time (β: 11.125, 95% CI: 7.963, 14.287) were significantly associated with admission PLC. Admission PLC increased with attack time up to the 3 days (β: 16.2, 95% CI: 12.1, 20.2).
We found that increasing age, male patients, patients with lower serum levels of TFPI and higher serum levels of FDP, and patients with a shorter attack time were significantly associated with lower PLC at admission. Moreover, the turning point of attack time is 3 days after the onset of dissection.
血小板是凝血过程的关键组成部分，而入院时血小板计数低（PLC）与斯坦福A型急性主动脉夹层（AAD）患者的不良临床结局相关。
2013年1月至2014年7月，北京安贞医院共纳入130例连续接受斯坦福A型AAD手术的患者。收集患者术前的临床和实验室数据。采用多元回归分析确定入院时血小板计数低的独立因素。
校正后的多元回归分析显示，年龄（β：-1.069，95%置信区间[CI]：-2.109，-0.029）、性别（β：-29.973，95%CI：-56.512，-3.433）、组织因子途径抑制物（TFPI；β：0.197，95%CI：0.039，0.354）、纤维蛋白原降解产物（FDP）（β：-0.476，95%CI：-0.879，-0.074）和发病时间（β：11.125，95%CI：7.963，14.287）与入院时PLC显著相关。入院时PLC随发病时间增加至3天（β：16.2，95%CI：12.1，20.2）。
我们发现，年龄增加、男性患者、血清TFPI水平较低和血清FDP水平较高的患者以及发病时间较短的患者入院时PLC显著较低。此外，发病时间的转折点是夹层发作后3天。
