Zou Fei, Wu Mian-Tao, Wang Yong-Yi
Department of Oncology, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College/Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China.
Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China.
World J Gastrointest Surg. 2024 Nov 27;16(11):3437-3444. doi: 10.4240/wjgs.v16.i11.3437.
With the widespread use of hemocoagulase in patients with gastrointestinal bleeding, clinicians have become increasingly concerned about coagulation disorders associated with this medication. Risk factors for hypofibrinogenemia associated with hemocoagulase are poorly understood.
To determine risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.
We performed a retrospective analysis of the medical documentation of hospitalized patients treated with hemocoagulase for gastrointestinal bleeding. Hypofibrinogenemia was defined as a decrease in plasma fibrinogen concentration to less than 2.0 g/L. The included patients were divided into two groups: acquired hypofibrinogenemia group and non-hypofibrinogenemia group. We used logistic regression analysis to identify potential risk factors and established risk assessment criteria by employing a receiver operating characteristic curve.
There were 36 patients in the acquired hypofibrinogenemia group and 73 patients in the non-hypofibrinogenemia group. The hypofibrinogenemia group showed higher rates of intensive care unit admissions ( = 0.021), more female patients ( = 0.005), higher in-hospital mortality ( = 0.027), larger hemocoagulase doses ( = 0.026), more Packed Red Cells transfusions ( = 0.024), and lower baseline fibrinogen levels ( < 0.000). Binary logistic regression was employed to examine the risk factors associated with acquired hypofibrinogenemia. The analysis revealed that baseline fibrinogen [odds ratio (OR) 0.252, 95%CI: 0.137-0.464, < 0.000], total hemocoagulase doses (OR 1.074, 95%CI: 1.015-1.137, = 0.014), and female gender (OR 2.856, 95%CI: 1.015-8.037, = 0.047) were statistically significant risk factors.
Higher doses of total hemocoagulase, female gender, and a lower baseline fibrinogen level were risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.
随着血凝酶在胃肠道出血患者中的广泛应用，临床医生越来越关注与该药物相关的凝血障碍。与血凝酶相关的低纤维蛋白原血症的危险因素尚不清楚。
确定胃肠道出血患者中血凝酶相关低纤维蛋白原血症的危险因素。
我们对因胃肠道出血接受血凝酶治疗的住院患者的医疗记录进行了回顾性分析。低纤维蛋白原血症定义为血浆纤维蛋白原浓度降至低于2.0g/L。纳入的患者分为两组：获得性低纤维蛋白原血症组和非低纤维蛋白原血症组。我们使用逻辑回归分析来识别潜在的危险因素，并通过绘制受试者工作特征曲线建立风险评估标准。
获得性低纤维蛋白原血症组有36例患者，非低纤维蛋白原血症组有73例患者。低纤维蛋白原血症组入住重症监护病房的比例更高（P = 0.021），女性患者更多（P = 0.005），院内死亡率更高（P = 0.027），血凝酶剂量更大（P = 0.026），红细胞输注量更多（P = 0.024），基线纤维蛋白原水平更低（P < 0.000）。采用二元逻辑回归分析与获得性低纤维蛋白原血症相关的危险因素。分析显示，基线纤维蛋白原[比值比（OR）0.252，95%置信区间：0.137 - 0.464，P < 0.000]、血凝酶总剂量（OR 1.074，95%置信区间：1.015 - 1.137，P = 0.014）和女性性别（OR 2.856，95%置信区间：1.015 - 8.037，P = 0.047）是具有统计学意义的危险因素。
高剂量的血凝酶总剂量、女性性别和较低的基线纤维蛋白原水平是胃肠道出血患者血凝酶相关低纤维蛋白原血症的危险因素。
