Zhang Naidan, Sun Jiaxiang, Ji Chaixia, Zhou Yusha, Bao Xiao, Yuan Chengliang
Department of Clinical Laboratory, Peoples Hospital of Deyang City, Deyang.
Department of Clinical Laboratory, West China Hospital of Sichuan University, Chengdu.
Medicine (Baltimore). 2020 Sep 25;99(39):e22424. doi: 10.1097/MD.0000000000022424.
Hypercoagulable is an important pathological state in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Fibrinogen (FIB) is the main protein in coagulation process. In this study, we aimed to investigate the clinical significance and influencing factors of FIB in AAV from Southwest China.A retrospective study was performed on AAV patients from Peoples Hospital of Deyang City from January 2007 to December 2018. Demographic and clinical characteristics were collected.A total of 463 AAV patients were included. In Wilcoxon rank sum test, FIB was significantly higher in AAV active group than inactive group (P = .005). FIB was also higher in bacterial infection group than in non-infection group both in active group (P = .008) and inactive group (P = .017). In receiver operating characteristic (ROC) curve analysis, the critical value of FIB for diagnosis of bacterial infection between AAV active and inactive groups was 3.385 g/L (P = .030), with sensitivity of 70.2% and specificity of 52.9%. In the multivariate analysis of variance (MANOVA), estimated glomerular filtration rate (eGFR) was shown to be an independent factor for FIB (P = .001). Least-significant difference showed the concentration of FIB (P < .05) increased with renal impairment, especially in endstage kidney disease (ESKD).FIB identified a certain reference value in distinguishing AAV activity from bacterial infection. ESKD had a statistical effect on it. Influencing factors of FIB should be evaluated based on the renal function impairment of patients.
高凝状态是抗中性粒细胞胞浆抗体相关性血管炎（AAV）的一种重要病理状态。纤维蛋白原（FIB）是凝血过程中的主要蛋白质。在本研究中，我们旨在探讨中国西南地区AAV患者中FIB的临床意义及影响因素。
对2007年1月至2018年12月德阳市人民医院的AAV患者进行了一项回顾性研究。收集了人口统计学和临床特征。
共纳入463例AAV患者。在Wilcoxon秩和检验中，AAV活动组的FIB显著高于非活动组（P = 0.005）。在活动组（P = 0.008）和非活动组（P = 0.017）中，细菌感染组的FIB也高于非感染组。在受试者工作特征（ROC）曲线分析中，AAV活动组和非活动组诊断细菌感染的FIB临界值为3.385 g/L（P = 0.030），敏感性为70.2%，特异性为52.9%。在多变量方差分析（MANOVA）中，估计肾小球滤过率（eGFR）被证明是FIB的一个独立因素（P = 0.001）。最小显著差异显示FIB浓度（P < 0.05）随肾功能损害而增加，尤其是在终末期肾病（ESKD）中。
FIB在区分AAV活动与细菌感染方面具有一定的参考价值。ESKD对其有统计学影响。应根据患者的肾功能损害情况评估FIB的影响因素。
