白眉蛇毒血凝酶治疗食管胃静脉曲张破裂出血致严重低纤维蛋白原血症的相关因素

张英; 苏婷婷; 邱源旺; 周学士; 毛燕群; 过小叶

doi:10.3969/j.issn.1671-038X.2019.01.13

白眉蛇毒血凝酶治疗食管胃静脉曲张破裂出血致严重低纤维蛋白原血症的相关因素

- 无锡市第五人民医院感染病重症医学科, 江苏无锡 214005
基金项目:
无锡市医学发展学科建设项目（No：FZXK006）

详细信息

通讯作者: 苏婷婷,E-mail:xiaoyuss@163.com

中图分类号: R575.2

收稿日期: 2018-09-20

Factors related to severe hypofibrinogenemia caused by hemocoagulase in patients with esophageal and gastric variceal bleeding

- Department of Infectious disease ICU, the Fifth People's Hospital of Wuxi, Wuxi 214000, China

More Information

Corresponding author: SU Ting-ting, E-mail: xiaoyuss@163.com

Received Date: 20 September 2018

摘要

摘要: [目的]分析白眉蛇毒血凝酶治疗肝硬化食管胃静脉曲张破裂出血发生严重低纤维蛋白原血症的相关影响因素。[方法]回顾性分析460例接受白眉蛇毒血凝酶治疗的肝硬化食管胃静脉曲张破裂出血患者，根据是否发生严重低纤维蛋白原血症分为发生组和未发生组，分析年龄、性别、肝硬化类型、血小板计数水平、肝功能Child-Pugh分级、基线凝血酶原时间（PT）、纤维蛋白原（Fib）、凝血酶时间（TT）、D-二聚体（DD）、活化部分凝血活酶（APTT）、白眉蛇毒血凝酶治疗时间、合并感染对患者发生严重低纤维蛋白原血症的影响。统计学处理采用t检验、χ²检验和Cox模型分析。[结果]发生组患者年龄、基线PT显著高于未发生组（t=2.973，3.187，均P<0.05），发生组患者基线Fib水平显著低于未发生组（t=-3.711，P<0.05）。2组间患者在治疗基线、3、7、10天Fib水平、PT比较差异均有统计学意义（t=-3.711，-5.945，-6.301，-6.592和3.187，4.047，5.477，6.987，均P<0.05）。治疗4~7、8~10 d严重低纤维蛋白原血症的发生率分别为4.3%（20/460）、6.5%（30/460），显著高于治疗3天的发生率（χ²=10.882和20.530，均P<0.01），多因素Cox模型分析结果显示白眉蛇毒血凝酶治疗时间是发生严重低纤维蛋白原血症的独立影响因素。[结论]肝硬化门静脉高压症合并上消化道出血患者采用白眉蛇毒血凝酶治疗发生严重低纤维蛋白原血症与治疗时间相关。
- 白眉蛇毒血凝酶 /
- 门静脉高压症 /
- 消化道出血 /
- 不良反应
Abstract: [Objective] To study the factors related to severe hypofibrinogenemia caused by hemocoagulase in cirrhotic patients with esophageal and gastric variceal bleeding.[Methods] A retrospective analysis was made in 460 cirrhotic patients with esophageal and gastric variceal bleeding who treated with hemocoagulase. We devided the patients into two groups according to the occurrence of severe hypofibrinogen, and the related factors of the age, sex, type of cirrhosis, baseline blood platelets, Child-Pugh class of liver function, Prothrombin time, Fibrinogen, Thrombin time, Activated partial thromboplastin time, the time of hemocoagulase treatment and co-infection were analyzed in these patients. T test, Chi square test and Cox regression were used for statistical analysis. [Results] The age and the baseline prothrombin time in the occurring group were significantly higher than that in the non occurring group, and the baseline fibrinogen level in the group was significantly lower than that in the non occurring group (all P<0.05). The differences in fibrinogen level and prothrombin time between the 2 groups were statistically significant in the baseline, the 3, 7 and 10 days(all P<0.05). The incidence of severe hypofibrinogen in 4~7 and 8~10 days were 4.3% (20/460) and 6.5% (30/460), which was significantly higher than that of 3 days (all P<0.05). Treatment time of hemocoagulase was the only factor associated to severe hypofibrinogenemia by multivariate Cox model analysis. [Conclusion] Longer course of treatment with hemocoagulase are risk factors related to severe hypofibrinogen in hepatitis cirrhotic portal hypertension patients with esophageal and gastric variceal bleeding who treated with hemocoagulase.
- hemocoagulase /
- portal hypertension /
- gastrointestinal bleeding /
- adverse reactions

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参考文献(8)

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