Volume 20 Issue 3
Mar.  2022
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(3): 407-410
MAO Xiao-qiang, JIN Jing, YU Guo-feng. Relationship between coagulation and fibrinolysis imbalance and severity of craniocerebral injury and its predictive value for acute traumatic coagulopathy[J]. Chinese Journal of General Practice, 2022, 20(3): 407-410. doi: 10.16766/j.cnki.issn.1674-4152.002364
Citation: MAO Xiao-qiang, JIN Jing, YU Guo-feng. Relationship between coagulation and fibrinolysis imbalance and severity of craniocerebral injury and its predictive value for acute traumatic coagulopathy[J]. Chinese Journal of General Practice, 2022, 20(3): 407-410. doi: 10.16766/j.cnki.issn.1674-4152.002364
shu

Relationship between coagulation and fibrinolysis imbalance and severity of craniocerebral injury and its predictive value for acute traumatic coagulopathy

doi: 10.16766/j.cnki.issn.1674-4152.002364
  • 1.

    Emergency Department of Quzhou People's Hospital, Quzhou, Zhejiang 324000, China

Funds:

 2017KY697

  • Received Date: 2021-04-06
    Available Online: 2022-08-13
    Abstract
  •   Objective  To analyse the relationship between coagulation and fibrinolysis imbalance and the severity of craniocerebral injury and its predictive value in acute traumatic coagulopathy.  Methods  A total of 145 patients with craniocerebral injury admitted to our hospital from January 2017 to October 2020 were selected as subjects. The severity of the patients was evaluated by Glasgow Coma Scale (GCS), and patients were divided into the severe group and non-severe group. The ratio of thrombin-antithrombin complex (TAT)/plasminolysin-α2 plasminolytic inhibitor complex (PIC) was used to evaluate the degree of coagulation-fibrinolytic imbalance. The coagulation function indexes and the ratio of TAT/PIC were compared between the two groups. The predictive effect of TAT/PIC ratio on acute traumatic coagulopathy was evaluated by area under the receiver operating characteristic (ROC) curve (AUC).  Results  The activated partial thromboplastin time (APTT) in the severe group was longer than that in the non-severe group[(33.69±8.16) s vs. (25.43±5.87) s], the level of D-dimer was higher than that in the non-severe group[(3.57±1.23) mg/L vs. (1.47±0.47) mg/L], and the TAT/PIC ratio was lower than that in the non-severe group[(0.75±0.11) ×10-3 vs. (1.77±0.24) ×10-3], the difference was statistically significant (P < 0.05). Pearson correlation analysis showed that the TAT/PIC ratio was positively correlated with GCS score (P < 0.05). Amongst 145 patients with craniocerebral injury, 21 cases (14.48%) had acute traumatic coagulopathy. The TAT/PIC ratio of the acute traumatic coagulation disease group was significantly decreased after admission, and the TAT/PIC ratio at 12 and 24 h after admission was significantly decreased compared with that at admission, the difference was statistically significant (all P < 0.05). Multivariate logistic regression analysis showed that the TAT/PIC ratio, APTT and D-dimer were independent predictors of acute traumatic coagulation disease (all P < 0.05). Using ROC curve analysis, the AUC of the TAT/PIC ratio in predicting acute traumatic coagulopathy was 0.918.  Conclusion  Coagulation-fibrinolysis imbalance is positively correlated with the severity of craniocerebral injury, and the decrease of TAT/PIC ratio indicates a greater risk of acute traumatic coagulopathy.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    王俊杰, 张祖勇. 不同病情程度颅脑损伤患者血清皮质醇浓度动态变化及临床意义的研究[J]. 中华全科医学, 2018, 16(3): 410-412. doi: 10.16766/j.cnki.issn.1674-4152.000114

    WANG J J, ZHANG Z Y. Clinical significance of dynamic serum cortisol level in patients with different severity of brain injury[J]. Chinese Journal of General Practice, 2018, 16(3): 410-412. doi: 10.16766/j.cnki.issn.1674-4152.000114
    [2]
    WADA T, GANDO S, MAEKAW K, et al. Disseminated intravascular coagulation with increased fibrinolysis during the early phase of isolated traumatic brain injury[J]. Crit Care, 2017, 21(1): 219. doi: 10.1186/s13054-017-1808-9
    [3]
    魏捷, 张东梅, 吕菁君, 等. 119例脓毒症凝血, 抗凝和纤溶功能的临床研究[J]. 中华急诊医学杂志, 2018, 27(8): 905-911. doi: 10.3760/cma.j.issn.1671-0282.2018.08.017

    WEI J, ZHANG D M, LYU J J, et al. A clinical study of sepsis-related coagulation disorder[J]. Chinese Journal of Emergency Medicine, 2018, 27(8): 905-911. doi: 10.3760/cma.j.issn.1671-0282.2018.08.017
    [4]
    中国研究型医院学会卫生应急学专业委员会, 中国中西医结合学会灾害医学专业委员会. 急性创伤性凝血功能障碍与凝血病诊断和卫生应急处理专家共识(2016)[J]. 中华卫生应急电子杂志, 2016, 2(4): 197-203. https://www.cnki.com.cn/Article/CJFDTOTAL-YJWS201604001.htm

    Health Emergency Committee of Chinese Research Hospital Association, Disaster Medicine Professional Committee of Chinese Association of Integrated Traditional Chinese and Western Medicine. Expert Consensus on Diagnosis and health emergency management of acute Traumatic coagulopathy and coagulopathy (2016)[J]. Chinese Journal of Hygiene Rescue (Electronic Edition), 2016, 2(4): 197-203. https://www.cnki.com.cn/Article/CJFDTOTAL-YJWS201604001.htm
    [5]
    LIRAS I N, CAPLAN H W, STENSBALLE J, et al. Prevalence and impact of admission acute traumatic coagulopathy on treatment Intensity, resource use, and mortality: An evaluation of 956 severely injured children and adolescents[J]. J Am Coll Surg, 2017, 224(4): 625-632. doi: 10.1016/j.jamcollsurg.2016.12.046
    [6]
    吕学文, 杨永康, 张小雷, 等. 创伤性颅脑损伤患者凝血功能及炎性因子的变化研究[J]. 临床外科杂志, 2019, 27(3): 247-249. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWK201903023.htm

    LYU X W, YANG Y K, ZHANG X L, et al. Changes of coagulation function and inflammatory factors in patients with traumatic craniocerebral injury[J]. Journal of Clinical Surgery, 2019, 27(3): 247-249. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWK201903023.htm
    [7]
    李力卓, 何松柏, 赵格晶娃. 中老年人群急性单发性创伤性颅脑损伤相关性凝血病的临床分析[J]. 首都医科大学学报, 2018, 39(4): 537-540. doi: 10.3969/j.issn.1006-7795.2018.04.011

    LI L Z, HE S B, ZHAO G J W. Clinical analysis of acute isolated traumatic brain injury-associated coagulopathy in middle aged and older populations[J]. Journal of Capital Medical University, 2018, 39(4): 537-540. doi: 10.3969/j.issn.1006-7795.2018.04.011
    [8]
    LEE K, BAKER L, MALLETT S, et al. Hypercoagulability progresses to hypocoagulability during evolution of acetaminophen-induced acute liver injury in pigs[J]. Sci Rep, 2017, 7(1): 9347. doi: 10.1038/s41598-017-09508-3
    [9]
    崔婵娟, 崔巍, 高佳, 等. 凝血酶-抗凝血酶复合物和纤溶酶-ɑ2纤溶酶抑制物复合物优于D二聚体用于肿瘤患者血栓的诊断[J]. 中华检验医学杂志, 2019, 42(10): 853-854, 857. doi: 10.3760/cma.j.issn.1009-9158.2019.10.008

    CUI C J, CUI W, GAO J, et al. TAT and PIC better than D-dimer in monitoring hypercoagulability of cancer patients[J]. Chinese Journal of Laboratory Medicine, 2019, 42(10): 853-854, 857. doi: 10.3760/cma.j.issn.1009-9158.2019.10.008
    [10]
    苗树船, 王晓燕, 王恩任, 等. 颅脑损伤患者凝血功能与伤情严重程度及预后的相关性研究[J]. 重庆医学, 2019, 48(18): 3148-3150. doi: 10.3969/j.issn.1671-8348.2019.18.021

    MIAO S C, WANG X Y, WANG E R, et al. Correlation of coagulation function with the severity and prognosis of craniocerebral injury[J]. Chongqing Medicine, 2019, 48(18): 3148-3150. doi: 10.3969/j.issn.1671-8348.2019.18.021
    [11]
    KITAYAMA H, KONDO T, SUGIYAMA J, et al. Venous thromboembolism in hospitalized patients receiving chemotherapy for malignancies at Japanese community hospital: Prospective observational study[J]. BMC Cancer, 2017, 17(1): 351. doi: 10.1186/s12885-017-3326-1
    [12]
    林宁, 姚国权, 李军, 等. D-二聚体与颅脑损伤后进展性出血性损伤的关系研究[J]. 中华全科医学, 2017, 15(7): 1123-1126. doi: 10.16766/j.cnki.issn.1674-4152.2017.07.009

    LIN N, YAO G Q, LI J, et al. Clinical study of D-dimer level in patients with progressive hemorrhagic injury after traumatic brain injury[J]. Chinese Journal of General Practice, 2017, 15(7): 1123-1126. doi: 10.16766/j.cnki.issn.1674-4152.2017.07.009
    [13]
    CHAUDHARY P K, KIN S, JEE Y, et al. Role of GRK6 in the regulation of platelet activation through selective G Protein-Coupled Receptor (GPCR) desensitization[J]. Int J Mol Sci, 2020, 21(11): 3932. doi: 10.3390/ijms21113932
    [14]
    GAO Z, PEI X, HE C, et al. Oxygenation impairment in patients with acute aortic dissection is associated with disorders of coagulation and fibrinolysis: A prospective observational study[J]. J Thorac Dis, 2019, 11(4): 1190-1201. doi: 10.21037/jtd.2019.04.32
    [15]
    武晓灵, 喻莉, 龙鼎. suPAR及D-二聚体对创伤性颅脑损伤患者病情严重程度及预后的判断价值[J]. 实用医学杂志, 2017, 33(2): 234-237. doi: 10.3969/j.issn.1006-5725.2017.02.018

    WU X L, YU L, LONG D. Soluble urokinase plasminogen activator receptor and D-dimer for assessment of disease severity and prognosis in traumatic brain injury[J]. The Journal of Practical Medicine, 2017, 33(2): 234-237. doi: 10.3969/j.issn.1006-5725.2017.02.018
    [16]
    JOSEPH C, ANDERSSON N, BJELAK S, et al. Incidence, aetiology and injury characteristics of traumatic spinal cord injury in Stockholm, Sweden: A prospective, population-based update[J]. J Rehabil Med, 2017, 49(5): 431-436. doi: 10.2340/16501977-2224
    [17]
    HIFUMI T, KURODA Y, KAWAKITA K, et al. Therapeutic hypothermia in patients with coagulopathy following severe traumatic brain injury[J]. Scand J Trauma Resusc Emerg Med, 2017, 25(1): 120. doi: 10.1186/s13049-017-0465-y
    [18]
    REED C R, WILLIAMSON H, VATSAAS C, et al. Higher mortality in pediatric and adult trauma patients with traumatic coagulopathy, using age-adjusted diagnostic criteria[J]. Surgery, 2019, 165(6): 1108-1115. doi: 10.1016/j.surg.2019.03.003
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (130) PDF downloads(1) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return