摘要
目的探讨影响创伤性颅脑损伤(TBI)患者发生血小板功能障碍的危险因素。方法回顾性分析南宁市第二人民医院神经外科自2020年7月至2021年12月收治的97例因TBI住院的患者的临床资料。收集资料包括:性别、年龄、GCS评分、是否多发伤、是否存在颅脑开放伤、纤维蛋白原浓度、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板数量及血小板功能。根据最大血凝块坚固度值将患者分为血小板功能障碍组(MA值<50 mm)和血小板功能正常组(50≤MA值≤70)。采用单因素和多因素Logistic回归分析法判断影响TBI后出现血小板功能障碍的危险因素。绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评估相关危险因素对TBI后出现血小板功能障碍的预测价值。结果97例患者中,血小板功能障碍组38例,血小板功能正常组59例。单因素分析结果显示2组患者的GCS评分、纤维蛋白原浓度、PT、APTT、血小板数量、血小板功能比较,差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,GCS评分(OR=0.765,95%CI:0.618~0.947)、纤维蛋白原浓度(OR=0.073,95%CI:0.014~0.387)是TBI患者出现血小板功能障碍的影响因素(P<0.05);GCS评分的AUC为0.827(95%CI:0.618~0.947),纤维蛋白原浓度的AUC为0.915(95%CI:0.014~0.387)。结论TBI后低GCS评分、低纤维蛋白原浓度易出现血小板功能障碍,其中,GCS评分具有一定的预测准确性,纤维蛋白原浓度具有较高的预测准确性。
ObjectiveTo explore the related risk factors in platelet dysfunction in patients with traumatic brain injury(TBI).MethodsThe clinical data of 97 patients with craniocerebral trauma in the Neurosurgery Department of Nanning Second People’s Hospital from July 2020 to December 2021 were retrospectively analyzed.The clinical data include:gender,age,GCS score,multiple trauma,open craniocerebral trauma,fibrinogen concentration,prothrombin time(PT),activated partial thromboplastin time(APTT),platelet count and platelet function were collected after hospitalization.Patients were divided into abnormal platelet function group(MA value<50 mm)and normal platelet function group(50≤MA value≤70)according to the maximum blood clot firmness value.Univariate and multivariate Logistic regression analysis were used to determine the risk factors in platelet dysfunction after TBI.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to evaluate the predictive value of the related risk factors for platelet dysfunction after TBI.ResultsAmong 97 patients,38 patients were in abnormal platelet function group and 59 patients in normal platelet function group.The results of single factor analysis showed that there were significant differences between the two groups in GCS score,fibrinogen concentration,PT,APTT,platelet number and platelet function(P<0.05).The results of binary Logistic regression analysis showed that the GCS score(OR=0.765,95%CI:0.618-0.947),fibrinogen concentration(OR=0.073,95%CI:0.014-0.387)were the influencing factors of platelet dysfunction in patients with TBI(P<0.05);AUC of GCS score is 0.827(95%CI:0.618-0.947),AUC of fibrinogen concentration is 0.915(95%CI:0.014-0.387).ConclusionLow GCS score and low fibrinogen concentration are prone to platelet dysfunction after TBI.Among them,the GCS score has a certain predictive accuracy,and the fibrinogen concentration has a high predictive accuracy.
作者
罗凯
吴声田
沈合春
李智恒
唐彪
廖燕
姚洁民
符黄德
Luo Kai;Wu Shengtian;Shen Hechun;Li Zhiheng;Tang Biao;Liao Yan;Yao Jiemin;Fu Huangde(Department of Neurosurgery,The Second People’s Hospital,Nanning 530000,China;Department of Blood Transfusion,The Second People’s Hospital,Nanning 530000,China)
出处
《中华神经创伤外科电子杂志》
2022年第6期341-345,共5页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
基金
广西卫健委自筹基金项目(z20200724)
南宁市科学研究与技术开发计划课题(20183041-3)
关键词
颅脑损伤
血小板功能障碍
因素分析
Traumatic brain injury
Platelet dysfunction
Factor analysis
