周晓钰, 王春, 桑庆庆, 宋传旺, 桑道乾. 多发性硬化病人凝血功能指标水平的临床意义[J]. 蚌埠医科大学学报, 2023, 48(10): 1351-1355. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.005
    引用本文: 周晓钰, 王春, 桑庆庆, 宋传旺, 桑道乾. 多发性硬化病人凝血功能指标水平的临床意义[J]. 蚌埠医科大学学报, 2023, 48(10): 1351-1355. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.005
    ZHOU Xiao-yu, WANG Chun, SANG Qing-qing, SONG Chuan-wang, SANG Dao-qian. Clinical significance of the coagulation function index levels in patients with multiple sclerosis[J]. Journal of Bengbu Medical University, 2023, 48(10): 1351-1355. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.005
    Citation: ZHOU Xiao-yu, WANG Chun, SANG Qing-qing, SONG Chuan-wang, SANG Dao-qian. Clinical significance of the coagulation function index levels in patients with multiple sclerosis[J]. Journal of Bengbu Medical University, 2023, 48(10): 1351-1355. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.005

    多发性硬化病人凝血功能指标水平的临床意义

    Clinical significance of the coagulation function index levels in patients with multiple sclerosis

    • 摘要:
      目的探讨活动期多发性硬化(MS)病人的凝血功能指标水平的临床意义。
      方法选取44例活动期MS病人为研究对象(MS组);同时选取88名健康体检者为对照组,2组分别抽取5 mL空腹静脉血为标本,比较2组之间纤维蛋白原、D-二聚体、活化部分凝血活酶时间、血浆凝血酶原时间、凝血酶时间水平的差异。利用Spearman相关分析EDSS评分与纤维蛋白原、D-二聚体、活化部分凝血活酶时间、血浆凝血酶原时间、凝血酶时间、血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血小板、肌酐的相关性;用多元回归分析进一步证明EDSS评分与上述血液指标相关性;ROC曲线评价纤维蛋白原、活化部分凝血活酶时间对活动期多发性硬化的敏感度、特异性。
      结果MS组血浆纤维蛋白原、D-二聚体水平均高于对照组(P < 0.01)。MS组的活化部分凝血活酶时间低于对照组(P < 0.01)。纤维蛋白原水平与EDSS评分呈正相关关系(B=0.623, P < 0.05)、活化部分凝血活酶时间水平与EDSS评分呈负相关关系(B=-0.187, P < 0.05)。纤维蛋白原、活化部分凝血活酶时间预测MS活动的敏感度分别为47.73%、70.45%,特异性为60.47%、80.68%。
      结论纤维蛋白原升高、活化部分凝血活酶时间水平缩短可能是MS严重程度的危险因素。MS病人可定期检测凝血功能指标,对于高水平纤维蛋白原、D-二聚体、活化部分凝血活酶时间的MS病人应警惕MS活动。

       

      Abstract:
      ObjectiveTo explore the clinical significance of the coagulation function index levels in patients with active multiple sclerosis(MS).
      MethodsForty-four patients with active MS and 88 healthy people were divided into the MS group and control group, respectively.The 5 mL of fasting venous blood in two groups were collected.The levels of fibrinogen, D-dimer, activated partial thromboplastin time, plasma prothrombin time and thrombin time were compared between two groups.The correlation between the EDSS score and levels of fibrinogen, D-dimer, activated partial thromboplastin time, plasma prothrombin time, thrombin time, serum alanine aminotransferase, aspartate aminotransferase, platelets and creatinine were analyzed using Spearman correlation analysis.The multiple regression analysis was used to further prove the correlation between the EDSS score and above blood indicators.The ROC curve was used to evaluate the sensitivity and specificity of fibrinogen and activated partial thromboplastin time to active MS.
      ResultsThe levels of plasma fibrinogen and D-dimer in MS group were higher than those in control group(P < 0.01).The activated partial thromboplastin time in MS group was lower than that in control group(P < 0.01).The fibrinogen level was positively correlated with EDSS score(B=0.623, P < 0.05), and the activated partial thromboplastin time level was negatively correlated with EDSS score(B=-0.187, P < 0.05).The sensitivity and specificity of the fibrinogen and activated partial thromboplastin time in predicting the activity of MS were 47.73% & 70.45% and 60.47% & 80.68%, respectively.
      ConclusionsIncreased fibrinogen and shortened activated partial thrombin time may be the risk factors of the severity of MS.The coagulation function indicators in patients with MS should be regularly tested, and patients with high levels of fibrinogen, D-dimer and activated partial thromboplastin time should be vigilant against MS activity.

       

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