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凝血功能障碍相关临床因素:一项回顾性观察研究

Associated Clinical Factors for Coagulation Dysfunction due to : A Retrospective Observational Study.

作者信息

Xie Run-Hua, Ye Xiao-Lu, Tang Cong-Yao, Wang Yu-Huai, Zhong Long-Xin

机构信息

Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, China.

出版信息

J Toxicol. 2023 Apr 30;2023:8832355. doi: 10.1155/2023/8832355. eCollection 2023.

Abstract

BACKGROUND

(T.s) accounts for most snakebites in southern China, which always leads to coagulation dysfunction. Coagulopathy due to venom is widely considered to be a characteristic phenomenon of the DIC-like syndrome. It is vitally important for first-line clinicians to improve this condition as soon as possible. However, clinical factors associated with coagulation function in has not been well characterized yet.

MATERIALS

Patients bitten by vipers were admitted to the Emergency Department of a hospital in Shenzhen, southern China, from 2021 to 2022 and were retrospectively reviewed. Patient clinical characteristics and laboratory data were compared in the eligible patients bitten by T.s by their prothrombin time (PT), fibrinogen level (FIB), and platelet count on 2-3 days after bitten.

RESULTS

105 patients were included in this study. The mean values of PT, FIB, and PLT are as follows: 12.8 ± 0.79 s, 2.25 ± 0.47 g/L, and 196.2 ± 57.1 × 10/L. Uric acid (UA) (367.9 ± 103.85), blood glucose (6.53 + 1.64) show negative trend of correlation, while CRP (2.12 + 4.17) shows positive trend of association with coagulation function. The smoke and systolic blood pressure may exert negative effects on PT and PLT, respectively. Logistic regression analysis indicated that uric acid (UA) shows significant connection with PT (OR = 1.15 and value <0.0001), FIB (OR = 0.89 and value = 0.026), and PLT (OR = 0.79 and value = 0.007). CRP is also shown to be associated with FIB (OR = 1.33 and value = 0.043).

CONCLUSION

: Uric acid (UA) shows a significant association with PT, FIB, and PLT. CRP is related to FIB. Blood glucose shows a negative trend of correlation with PT. We do recommend physician should low the level of UA in some degree on the basis of injection of an antivenom serum.

摘要

背景

竹叶青蛇咬伤在中国南方占大多数蛇咬伤病例,常导致凝血功能障碍。毒液所致的凝血病被广泛认为是类弥散性血管内凝血综合征的特征性现象。对于一线临床医生来说,尽快改善这种情况至关重要。然而,竹叶青蛇咬伤患者凝血功能相关的临床因素尚未得到很好的描述。

材料

回顾性分析了2021年至2022年在中国南方深圳一家医院急诊科收治的被蝰蛇咬伤的患者。根据凝血酶原时间(PT)、纤维蛋白原水平(FIB)和咬伤后2 - 3天的血小板计数,对符合条件的被竹叶青蛇咬伤患者的临床特征和实验室数据进行了比较。

结果

本研究纳入了105例患者。PT、FIB和PLT的平均值如下:12.8 ± 0.79秒、2.25 ± 0.47克/升和196.2 ± 57.1×10⁹/升。尿酸(UA)(367.9 ± 103.85)、血糖(6.53 + 1.64)与凝血功能呈负相关趋势,而C反应蛋白(CRP)(2.12 + 4.17)与凝血功能呈正相关趋势。吸烟和收缩压可能分别对PT和PLT产生负面影响。逻辑回归分析表明,尿酸(UA)与PT(比值比[OR]=1.15,P值<0.0001)、FIB(OR = 0.89,P值 = 0.026)和PLT(OR = 0.79,P值 = 0.007)有显著关联。CRP也与FIB相关(OR = 1.33,P值 = 0.043)。

结论

尿酸(UA)与PT、FIB和PLT有显著关联。CRP与FIB相关。血糖与PT呈负相关趋势。我们确实建议医生在注射抗蛇毒血清的基础上,在一定程度上降低尿酸水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9c2/10164868/1ba5466581fa/JT2023-8832355.001.jpg

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