一项关于预测急性脑静脉血栓形成严重程度和预后的新型标志物：D-二聚体与纤维蛋白原比值的回顾性队列研究。

A retrospective cohort study on a novel marker to predict the severity and prognosis of acute cerebral venous thrombosis: D-dimer to fibrinogen ratio.

作者信息

Lan Duo, Wang Mengqi, Zhang Xiaoming, Huang Xiangqian, Liu Naiqi, Ren Xiangyu, Fang Kun, Zhou Da, Meng Ran

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.

Capital Medical University, Beijing, 100069, China.

出版信息

Thromb J. 2024 Oct 30;22(1):95. doi: 10.1186/s12959-024-00664-x.

DOI:10.1186/s12959-024-00664-x

PMID:39478537

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11523772/

Abstract

BACKGROUND AND AIM

The D-dimer to fibrinogen ratio (DFR) represents an emerging and significant clinical biomarker. However, its correlation with cerebral venous thrombosis (CVT) remains underexplored. This retrospective cohort study aims to elucidate the association between DFR values and the severity and prognosis of CVT.

METHODS

Severe CVT was defined as the presence of at least 1 of the following risk factors: mental status disorder, coma state, intracranial cerebral hemorrhage, or thrombosis of the deep cerebral venous system. The modified Rankin Scale was utilized to assess functional outcomes. DFR measurements were obtained within 24 h of hospital admission. Logistic regression analysis was employed to determine the prognostic significance of DFR. After Bonferroni correction, a two-tailed P value < 0.017 (0.05/3) was considered statistically significant.

RESULT

A total of 196 patients were included in the study, among whom 85 patients were diagnosed with severe CVT, and 35 and 14 patients experienced short-term and long-term adverse outcomes, respectively. Receiver operating characteristic curve analysis demonstrated that DFR has predictive value for severe CVT, poor short-term and long-term outcomes, with area under the curve values of 0.690 [95% CI: 0.617-0.764, P < .001], 0.773 [95% CI: 0.701-0.845, P < .001], and 0.754 [95% CI: 0.619-0.886, P = .002], respectively. DFR ≥ 0.253 was identified as a significant predictor of severe CVT [adjusted odds ratio (aOR) (95% CI): 2.03 (1.10-3.75), P = .024]. Additionally, DFR ≥ 0.322 and DFR ≥ 0.754 were significantly associated with poor short-term outcomes at discharge [aOR (95% CI): 2.63 (1.43-4.76), P = .002] and poor long-term outcomes at 12 months [aOR (95% CI): 2.86 (1.32-6.25), P = .008], respectively.

CONCLUSION

Elevated DFR is associated with increased severity of CVT. Additionally, higher DFR levels can predict poorer clinical outcomes in CVT.

摘要

背景与目的

D - 二聚体与纤维蛋白原比值（DFR）是一种新兴且重要的临床生物标志物。然而，其与脑静脉血栓形成（CVT）的相关性仍未得到充分研究。这项回顾性队列研究旨在阐明DFR值与CVT严重程度及预后之间的关联。

方法

严重CVT定义为存在以下至少一种危险因素：精神状态障碍、昏迷状态、颅内脑出血或大脑深静脉系统血栓形成。采用改良Rankin量表评估功能结局。在入院24小时内进行DFR测量。采用逻辑回归分析确定DFR的预后意义。经过Bonferroni校正后，双侧P值<0.017（0.05/3）被认为具有统计学意义。

结果

本研究共纳入196例患者，其中85例被诊断为严重CVT，35例和14例分别经历了短期和长期不良结局。受试者工作特征曲线分析表明，DFR对严重CVT、短期和长期不良结局具有预测价值，曲线下面积值分别为0.690[95%CI：0.617 - 0.764，P <.001]、0.773[95%CI：0.701 - 0.845，P <.001]和0.754[95%CI：0.619 - 0.886，P =.002]。DFR≥0.253被确定为严重CVT的显著预测指标[调整优势比（aOR）（95%CI）：2.03（1.10 - 3.75），P =.024]。此外，DFR≥0.322和DFR≥0.754分别与出院时的短期不良结局[aOR（95%CI）：2.63（1.43 - 4.76），P =.002]和12个月时的长期不良结局[aOR（95%CI）：2.86（1.32 - 6.25），P =.008]显著相关。