BMC Gastroenterology: D-二聚体的升高与急慢性肝功能衰竭的28天死亡率增加相关

2019-02-23 不详 MedSci原创

急性慢性肝衰竭(ACLF)是一种以严重破坏的凝血和纤维蛋白溶解为特征的综合征。纤维蛋白溶解标记物D-二聚体在患有肝硬化的危重患者中增加,这与较差的预后相关。本项研究的目的是确定D-二聚体与ACLF患者28天死亡率的潜在关联。

背景
急性慢性肝衰竭(ACLF)是一种以严重破坏的凝血和纤维蛋白溶解为特征的综合征。纤维蛋白溶解标记物D-二聚体在患有肝硬化的危重患者中增加,这与较差的预后相关。本项研究的目的是确定D-二聚体与ACLF患者28天死亡率的潜在关联。

方法
研究人员收集了从2012年10月1日至2016年12月31日115例ACLF患者的数据,调查D-二聚体与其他实验室检查和预后评分之间的相关性。使用原始模型和调整模型进行逻辑回归分析以探索D-二聚体与ACLF患者中28天死亡率的关联。

结果
在ACLF患者中,入院时D-二聚体与所有预后评分相关(MELD-Na:r = 0.385,P <0.001; CLIF-C ADs:r = 0.443,P <0.001; CLIF-C ACLFs:r = 0.375,P <0.001)。同时研究人员发现D-二聚体与28天死亡率之间存在非线性关系,转折点为6.5 mg / L FEU。D-二聚体水平与28天死亡率独立相关,调整后的优势比[1.4(1.0-1.9),P = 0.030],截止值为6.5 mg / L FEU。在接下来的10天内升高的D-二聚体也倾向于与28天死亡率的较高风险相关[OR:27.5(0.9,814.9),P = 0.055]。

结论
升高的D-二聚体水平与中国ACLF患者28天死亡风险增加有关。

原始出处:

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encodeId=f0a020e2462f6, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Jul 03 09:15:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310856, encodeId=e567131085655, content=<a href='/topic/show?id=b15c5628e9' target=_blank style='color:#2F92EE;'>#D-二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5628, encryptionId=b15c5628e9, topicName=D-二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e093393, createdName=luwei00, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366716, encodeId=6e321366e163f, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504600, encodeId=48c515046004a, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=)]
    2019-09-05 hxj0117
  5. [GetPortalCommentsPageByObjectIdResponse(id=1944881, encodeId=8e93194488187, content=<a href='/topic/show?id=948a81192ea' target=_blank style='color:#2F92EE;'>#肝功能衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81192, encryptionId=948a81192ea, topicName=肝功能衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Tue Aug 20 16:15:00 CST 2019, time=2019-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974891, encodeId=3cbb19e48916b, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, 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encodeId=f0a020e2462f6, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Jul 03 09:15:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310856, encodeId=e567131085655, content=<a href='/topic/show?id=b15c5628e9' target=_blank style='color:#2F92EE;'>#D-二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5628, encryptionId=b15c5628e9, topicName=D-二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e093393, createdName=luwei00, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366716, encodeId=6e321366e163f, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504600, encodeId=48c515046004a, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1944881, encodeId=8e93194488187, content=<a href='/topic/show?id=948a81192ea' target=_blank style='color:#2F92EE;'>#肝功能衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81192, encryptionId=948a81192ea, topicName=肝功能衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Tue Aug 20 16:15:00 CST 2019, time=2019-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974891, encodeId=3cbb19e48916b, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, 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time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366716, encodeId=6e321366e163f, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504600, encodeId=48c515046004a, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=)]
    2019-07-03 许安
  7. 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time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366716, encodeId=6e321366e163f, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Feb 25 08:15:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504600, encodeId=48c515046004a, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, 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  8. 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  9. 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