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子宫腺肌病患者贫血相关血小板及血浆凝血酶原时间增加。

Anemia-Associated Platelets and Plasma Prothrombin Time Increase in Patients with Adenomyosis.

作者信息

Lin Qiao, Li Tiantian, Ding ShaoJie, Yu Qin, Zhang Xinmei

机构信息

Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

Taizhou Cancer Hospital, Taizhou 317502, China.

出版信息

J Clin Med. 2022 Jul 28;11(15):4382. doi: 10.3390/jcm11154382.

Abstract

Patients with adenomyosis are hypercoagulable and often accompanied by anemia, but the specific changes in anemia-related coagulation parameters are still unclear. This study investigated the changes in and influencing factors of coagulation parameters related to anemia in patients with adenomyosis (AM). The coagulation parameters, including platelet count (PC), plasma prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and fibrinogen (FB), and hemoglobin (Hb), were measured in patients with adenomyosis (229 cases in AM group), uterine leiomyoma (265 cases in LM group), and undergoing tubal anastomosis (142 cases in the control group). The age of the control group was younger than that of the AM group and the LM group. Compared with the AM and LM groups, the uterus size of the control group was smaller; the AM group was larger than the LM group. The Hb concentration of the AM group was lower than that of the LM and control groups. Compared with the LM and control groups, PC increased and TT shortened in the AM group. APTT in the AM group was shorter than in the control group, and PT was longer than in the LM group. After adjustment using multiple logistic regression analysis, adenomyosis was correlated with Hb concentration (or = 0.971, 95% CI 0.954−0.988, p < 0.001), PC (or = 1.006, 95% CI 1.002−1.011, p = 0.004), PT (or = 3.878, 95% CI 2.347−6.409, p < 0.001), age (or = 1.062, 95% CI 1.013−1.114, p = 0.013), and uterine size (or = 1.103, 95% CI 1.011−1.203, p = 0.028). Correlation analysis showed that PC (r = −0.309) and PT (r = −0.252) were negatively correlated with anemia. The increase in Hb-related PC and PT in patients with adenomyosis indicates that the timely and early detection of coagulation parameters is needed for patients with severe anemia, older age, and larger uterine volume.

摘要

子宫腺肌病患者具有高凝状态,且常伴有贫血,但贫血相关凝血参数的具体变化仍不清楚。本研究调查了子宫腺肌病(AM)患者贫血相关凝血参数的变化及其影响因素。对子宫腺肌病患者(AM组229例)、子宫肌瘤患者(LM组265例)及接受输卵管吻合术者(对照组142例)测定了凝血参数,包括血小板计数(PC)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FB),以及血红蛋白(Hb)。对照组年龄小于AM组和LM组。与AM组和LM组相比,对照组子宫体积较小;AM组大于LM组。AM组Hb浓度低于LM组和对照组。与LM组和对照组相比,AM组PC升高,TT缩短。AM组APTT短于对照组,PT长于LM组。经多因素logistic回归分析校正后,子宫腺肌病与Hb浓度(比值比=0.971,95%可信区间0.954−0.988,p<0.001)、PC(比值比=1.006,95%可信区间1.002−1.011,p=0.004)、PT(比值比=3.878,95%可信区间2.347−6.409,p<0.001)、年龄(比值比=1.062,95%可信区间1.013−1.114,p=0.013)及子宫大小(比值比=1.103,95%可信区间1.011−1.203,p=0.028)相关。相关性分析显示,PC(r=−0.309)和PT(r=−0.252)与贫血呈负相关。子宫腺肌病患者中与Hb相关的PC和PT升高表明,对于重度贫血、年龄较大及子宫体积较大的患者,需要及时、早期检测凝血参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5210/9369197/2aa9219ffaa4/jcm-11-04382-g001.jpg

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