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利用纤维蛋白原功能与浓度比值对成年脓毒症患者获得性异常纤维蛋白原血症的研究:一项横断面研究。

Investigation of acquired dysfibrinogenaemia in adult patients with sepsis using fibrinogen function vs. concentration ratios: a cross-sectional study.

作者信息

Toenges Rosa, Steiner Michael, Weber Christian Friedrich, Miesbach Wolfgang

机构信息

Department of Medicine, Hemostaseology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany.

Medizinisches Labor Rostock, Rostock, Germany.

出版信息

Front Med (Lausanne). 2023 Dec 13;10:1294301. doi: 10.3389/fmed.2023.1294301. eCollection 2023.

DOI:10.3389/fmed.2023.1294301
PMID:38152302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10752225/
Abstract

INTRODUCTION

Inherited or acquired molecular abnormalities form a clinically heterogeneous group of fibrinogen disorders called dysfibrinogenaemia. Apart from a pediatric case report and in contrast to other clinical conditions, acquired dysfibrinogenaemia has not been previously reported in septic patients.

METHODS

In an observational cohort study, 79 adult septic patients were investigated for the presence of acquired dysfibrinogenaemia at the time of their admission to the intensive care unit (ICU) of the University Hospital Frankfurt. Following established recommendations, fibrinogen clotting activity vs. antigen ratios were analyzed using Clauss fibrinogen, prothrombin-derived fibrinogen, and radial immunodiffusion (RID) fibrinogen concentration.

RESULTS

Prothrombin-derived fibrinogen levels were highest (527 ± 182 mg/dL) followed by Clauss fibrinogen (492 ± 209 mg/dL) and radial immunodiffusion fibrinogen (426 ± 159 mg/dL). Very few cases demonstrated hypofibrinogenaemia making overt disseminated intravascular coagulation (DIC) unlikely in the cohort investigated. Clauss/RID fibrinogen ratios were lower (1.17 ± 0.19) compared to prothrombin time-derived/RID ratios (1.35 ± 0.33). Using the Clauss/RID dataset, 21% of patients (16/76 patients) demonstrated values below a threshold ratio for suspected acquired dysfibrinogenaemia arbitrarily set at 1.0. In contrast, prothrombin-derived ratios were below the threshold in only 7% (4/58 patients).

DISCUSSION

The results point to the presence of acquired dysfibrinogenaemia in part of adult septic patients. If confirmed in further studies, this may form part of a specific laboratory signature of a sepsis-associated coagulation phenotype.

摘要

引言

遗传性或获得性分子异常形成了一组临床异质性的纤维蛋白原疾病,称为异常纤维蛋白原血症。除了一篇儿科病例报告外,与其他临床情况不同,此前尚未有关于脓毒症患者获得性异常纤维蛋白原血症的报道。

方法

在一项观察性队列研究中,对79名成年脓毒症患者在入住法兰克福大学医院重症监护病房(ICU)时进行了获得性异常纤维蛋白原血症的调查。按照既定建议,使用克劳斯纤维蛋白原法、凝血酶原衍生纤维蛋白原法和放射免疫扩散(RID)纤维蛋白原浓度分析法分析纤维蛋白原凝血活性与抗原比值。

结果

凝血酶原衍生纤维蛋白原水平最高(527±182mg/dL),其次是克劳斯纤维蛋白原(492±209mg/dL)和放射免疫扩散纤维蛋白原(426±159mg/dL)。很少有病例表现为纤维蛋白原减少血症,在所研究的队列中不太可能出现明显的弥散性血管内凝血(DIC)。与凝血酶原时间衍生/RID比值(1.35±0.33)相比,克劳斯/RID纤维蛋白原比值较低(1.17±0.19)。使用克劳斯/RID数据集,21%的患者(16/76例患者)的比值低于疑似获得性异常纤维蛋白原血症的阈值比值,该阈值比值被任意设定为1.0。相比之下,凝血酶原衍生比值仅7%(4/58例患者)低于阈值。

讨论

结果表明部分成年脓毒症患者存在获得性异常纤维蛋白原血症。如果在进一步研究中得到证实,这可能构成脓毒症相关凝血表型的特定实验室特征的一部分。

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本文引用的文献

1
Sepsis-Induced Coagulopathy: An Update on Pathophysiology, Biomarkers, and Current Guidelines.脓毒症诱导的凝血病:病理生理学、生物标志物及现行指南的最新进展
Life (Basel). 2023 Jan 28;13(2):350. doi: 10.3390/life13020350.
2
Acute obstetric coagulopathy during postpartum hemorrhage is caused by hyperfibrinolysis and dysfibrinogenemia: an observational cohort study.产后出血期间急性产科凝血病由高纤维蛋白溶解和异常纤维蛋白原血症引起:一项观察性队列研究。
J Thromb Haemost. 2023 Apr;21(4):862-879. doi: 10.1016/j.jtha.2022.11.036. Epub 2022 Dec 22.
3
Communication from the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis on sepsis-induced coagulopathy in the management of sepsis.
国际血栓与止血学会科学与标准化委员会关于脓毒症管理中脓毒症诱导的凝血障碍的通讯。
J Thromb Haemost. 2023 Jan;21(1):145-153. doi: 10.1016/j.jtha.2022.10.022. Epub 2022 Dec 22.
4
Comparison of Fibrinogen Concentrations Determined by the Clauss Method with Prothrombin-Derived Measurements on an Automated Coagulometer.Clauss 法测定纤维蛋白原浓度与自动化凝血仪测定凝血酶原时间的比较。
J Appl Lab Med. 2022 Oct 29;7(6):1337-1345. doi: 10.1093/jalm/jfac066.
5
Disorders of Fibrinogen and Fibrinolysis.纤维蛋白原和纤维蛋白溶解紊乱。
Hematol Oncol Clin North Am. 2021 Dec;35(6):1197-1217. doi: 10.1016/j.hoc.2021.07.011. Epub 2021 Aug 14.
6
Coagulopathy and sepsis: Pathophysiology, clinical manifestations and treatment.凝血功能障碍和脓毒症:病理生理学、临床表现和治疗。
Blood Rev. 2021 Nov;50:100864. doi: 10.1016/j.blre.2021.100864. Epub 2021 Jun 25.
7
The multifaceted role of fibrinogen in tissue injury and inflammation.纤维蛋白原在组织损伤和炎症中的多效性作用。
Blood. 2019 Feb 7;133(6):511-520. doi: 10.1182/blood-2018-07-818211. Epub 2018 Dec 6.
8
Diagnosis and classification of congenital fibrinogen disorders: communication from the SSC of the ISTH.先天性纤维蛋白原异常的诊断与分类:国际血栓与止血学会科学标准化委员会的通讯
J Thromb Haemost. 2018 Sep;16(9):1887-1890. doi: 10.1111/jth.14216. Epub 2018 Aug 3.
9
Combined use of Clauss and prothrombin time-derived methods for determining fibrinogen concentrations: Screening for congenital dysfibrinogenemia.联合使用Clauss法和凝血酶原时间衍生法测定纤维蛋白原浓度:先天性异常纤维蛋白原血症的筛查
J Clin Lab Anal. 2018 May;32(4):e22322. doi: 10.1002/jcla.22322. Epub 2017 Sep 18.
10
Clinical Features and Management of Congenital Fibrinogen Deficiencies.先天性纤维蛋白原缺乏症的临床特征与管理
Semin Thromb Hemost. 2016 Jun;42(4):366-74. doi: 10.1055/s-0036-1571339. Epub 2016 Mar 28.