摘要
目的探讨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特点。方法将收集于首都医科大学宣武医院和中国医科大学附属盛京医院的144例发病于2014年7月至2016年6月的急性单发性颅脑创伤的患者资料,按照1∶2配组分为中老年患者组和非中老年患者组,利用χ2检验进行统计学分析,比较中老年颅脑创伤患者创伤后凝血病的发病率与非中老年患者组差异是否有统计学意义,然后对中老年患者组和非中老年患者组的凝血功能障碍指标进行分析,明确凝血障碍指标在不同组别中的差异。结果中老年急性单发性颅脑创伤患者创伤后凝血病的发病率与非中老年患者组差异有统计学意义(P<0.05,χ2=4.11)。进一步分析表明血小板(platelet,PLT)异常在中老年患者组和非中老年患者组差异有统计学意义(P<0.05,χ2=4.68),而国际标准化比值(international normalized ratio,INR)、纤维蛋白原(fibrinogen,Fg)、凝血酶原时间(prothrombin time,PT)和活化部分凝血活酶时间(activated partial thromboplastin time,APTT)在两组患者之间差异无统计学意义(P>0.05)。结论中老年急性单发性颅脑创伤患者创伤后凝血病的发病率更高,同时血小板异常更容易出现在中老年颅脑创伤性凝血病患者组内,以上特点有助于明确中老年颅脑创伤性凝血病的病理机制并指导中老年患者颅脑创伤后凝血病的诊疗。
Objective To explore the clinical characters of acute isolated traumatic brain injury-associated coagulopathy in middle aged and older populations. Methods A retrospective study was performed at Xuanwu Hospital of Capital Medical University and Shengjing Hospital of China Medical University from July 2014 to June 2016. Totally 144 cases of acute isolated traumatic brain injury were included and divided into two groups including middle aged and older patients group and non-age group with the ratio of 1 ∶ 2. The chi-square analysis was used to investigate the prevalence,index and difference of coagulopathy in both groups. Results The prevalence of coagulopathy was higher in middle aged and older patients group than that of non-age group according to the chi-square analysis（P〈0. 05,χ^2= 4. 11）. Further,platelet count（PLT）,but not international normalized ratio（INR）,fibrinogen（Fg）,prothrombin time（PT） and activated partial thromboplastin time（APTT）,was significantly different between two groups and higher in middle aged and older patients group（P〈0. 05,χ^2= 4. 68）. Conclusion The higher prevalence of acute isolated traumatic brain injury-associated coagulopathy occurs in middle aged and older patients and PLT exists more likely in those populations. These findings will provide the guidance of the treatment of traumatic brain injury in middle aged and older patients in the clinical.
作者
李力卓
何松柏
赵格晶娃
Li Lizhuo;He Songbai;Zhaoge Jingwa(Department of Emergency Medicine,Xuanwu Hospital,Capital Medical University,National Clinical Research for Geriatric Disorders,Beijing 100053,China;Department of Emergency Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,China;The First Hospital of Capital Medical University,Grade 2015,Eight-year Program of Clinical Medicine /（Pediatrics）,Beijing 100053,China)
出处
《首都医科大学学报》
CAS
北大核心
2018年第4期537-540,共4页
Journal of Capital Medical University
基金
国家自然科学基金(81660329)
首都医科大学大学生创业项目(XSKY 2018)
关键词
中老年
急性单发性创伤性颅脑损伤
创伤性凝血病
凝血障碍指标
middle aged and older populations
acute isolated traumatic brain injury
traumatic coagulopathy
coaglution indices
