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SARS-CoV-2 感染患者凝血功能的显著变化。

Prominent changes in blood coagulation of patients with SARS-CoV-2 infection.

机构信息

Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, P.R. China.

Department of Clinical Laboratory, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai, P.R. China.

出版信息

Clin Chem Lab Med. 2020 Jun 25;58(7):1116-1120. doi: 10.1515/cclm-2020-0188.

DOI:10.1515/cclm-2020-0188
PMID:32172226
Abstract

Background As the number of patients increases, there is a growing understanding of the form of pneumonia sustained by the 2019 novel coronavirus (SARS-CoV-2), which has caused an outbreak in China. Up to now, clinical features and treatment of patients infected with SARS-CoV-2 have been reported in detail. However, the relationship between SARS-CoV-2 and coagulation has been scarcely addressed. Our aim is to investigate the blood coagulation function of patients with SARS-CoV-2 infection. Methods In our study, 94 patients with confirmed SARS-CoV-2 infection were admitted in Renmin Hospital of Wuhan University. We prospectively collect blood coagulation data in these patients and in 40 healthy controls during the same period. Results Antithrombin values in patients were lower than that in the control group (p < 0.001). The values of D-dimer, fibrin/fibrinogen degradation products (FDP), and fibrinogen (FIB) in all SARS-CoV-2 cases were substantially higher than those in healthy controls. Moreover, D-dimer and FDP values in patients with severe SARS-CoV-2 infection were higher than those in patients with milder forms. Compared with healthy controls, prothrombin time activity (PT-act) was lower in SARS-CoV-2 patients. Thrombin time in critical SARS-CoV-2 patients was also shorter than that in controls. Conclusions The coagulation function in patients with SARS-CoV-2 is significantly deranged compared with healthy people, but monitoring D-dimer and FDP values may be helpful for the early identification of severe cases.

摘要

背景

随着患者数量的增加,人们越来越了解导致中国疫情爆发的 2019 年新型冠状病毒(SARS-CoV-2)引起的肺炎类型。到目前为止,已经详细报道了感染 SARS-CoV-2 的患者的临床特征和治疗方法。然而,SARS-CoV-2 与凝血之间的关系尚未得到充分关注。我们的目的是研究 SARS-CoV-2 感染患者的凝血功能。

方法

在我们的研究中,共有 94 名确诊的 SARS-CoV-2 感染患者入住武汉大学人民医院。我们前瞻性地收集了这些患者和同期 40 名健康对照者的凝血数据。

结果

患者的抗凝血酶值低于对照组(p<0.001)。所有 SARS-CoV-2 病例的 D-二聚体、纤维蛋白/纤维蛋白原降解产物(FDP)和纤维蛋白原(FIB)值均明显高于健康对照组。此外,重症 SARS-CoV-2 感染患者的 D-二聚体和 FDP 值高于轻症患者。与健康对照组相比,SARS-CoV-2 患者的凝血酶原时间活动度(PT-act)较低。危重症 SARS-CoV-2 患者的凝血酶时间也短于对照组。

结论

与健康人相比,SARS-CoV-2 患者的凝血功能明显异常,但监测 D-二聚体和 FDP 值可能有助于早期识别重症患者。

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