Study on influencing factors of plasma FDP and D-dimer levels of newborns in NICU / 国际儿科学杂志

Objective:To investigate the influencing factors of physiological and pathological conditions at birth of newborn and gestational conditions of pregnant mothers on plasma fibrin/fibrinogen degradation products(FDP)and D-dimer levels.Methods:From May 1, 2018 to October 31, 2018, 222 newborns admitted to NICU of the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were enrolled in this study.Newborns were sent to NICU within 2 hours after birth and venous blood was collected immediately.The levels of FDP and D-dimer were detected by immunoturbidimetry.Groups were divided according to different gender, gestational age, birth weight, relationship between gestational age and birth weight, mode of delivery, asphyxia at birth, acidosis, antenatal hormone use, anticoagulant drugs, and perinatal risk factors(gestational hypertension, premature rupture of membranes, abnormal placenta, gestational diabetes). The levels of plasma FDP and D-dimer were compared among the groups.Mann Whitney U test, Kruskal Wallis H test, Spearman rank correlation and generalized linear model were used for statistical analysis. Results:The plasma FDP and D-dimer values of 222 NICU neonates were skewed at birth, with median values of 6.00 mg/L and 1.74 mg/L, and quartile distances of 10.40 mg/L and 2.55 mg/L, respectively.The concentrations of FDP in neonates born to natural labour and cesarean section were 11.70 mg/L and 5.30 mg/L, respectively, and D-dimer concentrations were 2.92 mg/L and 1.52 mg/L, respectively.The FDP and D-dimer levels were significantly higher in the former(Z values were -4.006 and -4.198, respectively, P<0.05). The levels of FDP and D-dimer in newborns with different gestational age, different birth weight and different blood pH values were compared respectively, and the differences were statistically significant( χ2 values were 15.322, 18.394, 9.677, 11.492, 7.023 and 8.345, respectively, P<0.05). Further analysis showed that the levels of FDP and D-dimer in neonates with gestational age < 34 weeks were significantly higher than those in~<37 weeks group and ≥37 weeks group( P<0.05). The FDP and D-dimer levels in the birth weight<1 500 g group were significantly higher than those in~<2 500 g group and ≥2 500 g group( P<0.05). Higher FDP and D-dimer levels were found in the pH<7.20 group than in the pH ≥7.35 group( P<0.05). A generalized linear model was established for multifactor analysis.The results showed that the concentration of FDP and D-dimer in plasma was related to gestational age, birth weight and arterial pH value. Conclusion:The levels of plasma FDP and D-dimer in NICU newborns at birth were influenced by gestational age, birth weight and acid-base balance.

Correlation study of serum homocysteine with renal function and coagulation indexes in hypertensive patients / 中华检验医学杂志

Objective The purpose of this study was to investigate the correlation of serum homocysteine with renal function and coagulation indexes in hypertensive patients .Methods Through retrospective design , 224 hypertensive patients and 212 healthy subjects who sought medical service in Henan Province Hospital of TCM during 2017 to 2018, were divided into four groups according to hypertension and homocysteine level, that was normotensive normal Hcy group (103 patients), normotensive high Hcy group (109 patients), hypertensive normal Hcy group (115 patients), and hypertensive high Hcy group ( 109 patients ) .Serum homocysteine , serum lipid and renal function indexes were detected by automatic biochemical analyzer .The level of coagulation indexes were detected by automatic coagulation analyzer and platelet was tested by automatic blood cell analyzer .Comparisons of variables between four groups were evaluated by one way ANOVA .The correlation was expressed by the Pearson′s correlation coefficient analysis.Multivariate linear regression analysis was performed to identify variables and influence factor associated with Hcy.Results The concentration of Urea in hypertensive high Hcy group (5.73 ± 1.67)mmol/L was significantly increased compared to normotensive normal Hcy group (4.79 ±1.05)mmol/L (t=3.508, P=0.001).The leve of Urea in hypertensive high Hcy group (5.73 ±1.67) mmol/L was significantly increased compared to normotensive high Hcy group (5.21 ±1.21) mmol/L ( t=1.983, P=0.049) and hypertensive normal Hcy group (4.81 ±1.21)mmol/L (t=3.600, P=0.000).The level of Crea in hypertensive high Hcy group ( 79.52 ±25.92 )μmol/L was significantly increased compared to normotensive normal Hcy group (58.39 ±12.83)μmol/L (t=6.121, P=0.000) and hypertensive normal Hcy group (60.93 ±13.74)μmol/L (t=5.526, P=0.000).The level of UA in hypertensive high Hcy group (389.96 ±96.03)μmol/L were significantly higher than normotensive normal Hcy group (293.65 ± 89.94)μmol/L (t=5.722, P=0.000),normotensive high Hcy group (327.02 ±66.55)μmol/L (t=3.837, P=0.000 ) and hypertensive normal Hcy group ( 291.50 ±73.42 )μmol/L ( t=6.128, P=0.000).The level of BMG,CysC in hypertensive high Hcy group and normotensive high Hcy group were higher than normotensive normal Hcy group and hypertensive normal Hcy group .The level of RBP ,D-Dimer, FDP in hypertensive high Hcy group were significantly higher than that of the other three groups .Serum homocysteine correlated positively with Urea (r=0.276,P=0.000),Crea(r=0.389,P=0.000),UA(r=0.339,P=0.000),BMG(r=0.221,P=0.002),RBP(r=0.396,P=0.000),CysC(r=0.200,P=0.006).Multivariate regression analysis showed that the Hcy level was the influencing factors of Urea , Crea and RBP, and hypertension was the influencing factor of Crea , UA, BMG RBP and CysC. Conclusions Hypertensive patients with hyperhomocysteinemia caused renal injury easily . Serum homocysteine may play an important role in renal injury and further affect the occurrence and development of hypertension by impairing the function of platelet , coagulation and fibrinolysis system .

Fibrinogen degradation product levels on arrival for trauma patients requiring a transfusion even without head injury / 世界急诊医学杂志（英文）

@#BACKGROUND:There have been few reports on the clinical significance of the fibrinogen degradation product (FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with or without head injury to investigate the clinical significance of the FDP level. METHODS:From April 2013 to June 2015, a medical chart review was retrospectively performed for all patients with trauma. The exclusion criteria included patients who did not receive a transfusion. The patients were divided into two groups:a FDP>100 group, which included patients who had an FDP level on arrival over 100 ng/mL, and a FDP≤100 group. RESULTS:The ratio of open fractures and the prothrombin ratio in the FDP>100 group were significantly smaller than those observed in the FDP≤100 group. The average age, ratio of blunt injury, Injury Severity Score (ISS), volume of transfusion and mortality ratio in the FDP>100 group were significantly greater than those in the FDP≤100 group. There was a weakly positive correlation between the FDP level and ISS (R=0.35, P=0.002), but it was not associated with the transfusion volume. The results of an analysis excluding patients with head injury showed a similar tendency. CONCLUSION:The FDP levels may be a useful biochemical parameter for the initial evaluation of the severity of trauma and mortality even in blunt traumatized patients without head injury or with stable vital signs.

Clinical significance of plasma D-dimer, fibrinogen and fibrin/fibrinogen degradation product detection in patients with chronic obstructive pulmonary disease / 中国医师进修杂志

Objective To investigate clinical significance of plasma D-dimer (D-D),fibrinogen (FIB) and fibrin/fibrinogen degradation product (FDP) in patients with chronic obstructive pulmonary disease (COPD).Methods The level of plasma D-D,FIB and FDP in 150 patients with COPD and 80 healthy persons were detected,and compared.Results The level of plasma D-D,FIB and FDP in COPD patients were significantly higher than those in healthy persons[(2.16 ± 0.61) mg/L vs.(0.55 ± 0.04) mg/L,(5.88 ± 1.52) g/L vs.(3.12 ± 0.35) g/L,(7.18 ± 1.63) mg/L vs.(3.62 ± 1.55) mg/L],there were significant differences (P ＜ 0.01).Conclusion Monitoring the level of plasma D-D,FIB and FDP in COPD patients can provide reliable basis in hypercoagulable state and primary and secondary hyperfibrinolysis.

Macrovascular dysfunction detected by comparison of serum FDP detected by simplified venous occlusion test in patients with NIDDM and CVA / 대한내과학회지

OBJECTIVES: In diabetic patients, the incidence of atherosclerotic disease are increased, which may be due to decreased fibrinolytic activity. The aim of study is to elucidate the relationship between angiopathies and vascular function evaluated by simplified venous occlusion test in patients with non-insulin dependent diabetes mellitus (NIDDM) and cerebrovascular accident (CVA). METHODS: The study was conducted on 63 patients who were hospitalized during the period from March 1, 1994 to May 30, 1997. The serum concentration of fibrinogen degradation products (FDP) was measured before and 5 min after venous occlusion in 31 NIDDM patients, 16 CVA patients and 16 age-matched control subjects. FDP was measured with the anti-fibrinogen- coated latex particle agglutinin assay system. RESULTS: 1) The basal serum FDP level was higher in diabetic patients with macroangiopathy (12.3+/-5.8 ug/ml) and patients with CVA (11.2+/-5.1 ug/ml) than in control subjects (5.7+/-1.8 ug/ml) (p<0.05). 2) The increment of serum FDP level after venous occlusion in diabetic patients with microangiopathy (6.6+/-2.2 to 10.3+/-4.1 ug/ml) and control subjects (5.7+/-1.8 to 11.4+/-4.3 ug/ml) was significantly higher than basal serum FDP level (p<0.05). But the increment of serum FDP level after venous occlusion in diabetic patients with macroangiopathy (12.3+/-5.8 to 15.2+/-5.1 ug/ml) and patients with CVA (11.2+/-5.1 to 13.7+/-4.8 ug/ml) wasn't significantly higher than basal serum FDP level. 3) The increment rate of serum FDP after venous occlusion in diabetic patients with macroangiopathy (24.4+/-29.3%) and patients with CVA (29.4+/-34.5%) was significantly lower than diabetic patients with microangiopathy (66.3+/-71.7%) and control subjects (84.1+/-69.3%) (p<0.05). CONCLUSION: The responsiveness of fibrinolytic activity to venous occlusion was significantly lower in diabetic patients with macroangiopathy, as in patients with CVA, compared with that in control subjects. We conclude that measurement of the increase in serum FDP concentration 5 min after venous occlusion may be useful to detect vascular dysfunction in patients with macrovascular disease caused by atherosclerosis.

The fibrinogen degradation products (FgDP) levels in liver disease

We measured plasma levels of fibrinogen degradation products (FgDP) with newly developed enzyme-linked immunosorbent assay based on monoclonal antibody to assess the fibrinogenolytic state in 52 patients with various liver diseases (27 patients with liver cirrhosis, 10 with chronic hepatitis, 7 with acute hepatitis, 6 with hepatocellular carcinoma, 2 with intrahepatic cholestasis). As compared with 20 healthy subjects (upper limit: 580 ng/ml), elevated plasma levels (660-32000 ng/ml) of FgDP were found in 19 (36.5%) patients. When analyzed according to the underlying disease categories, the magnitude of elevations of FgDP were most prominent in patients with chronic hepatitis. No correlation was found between plasma FgDP levels and serum AST or ALT activity. These findings indicate that increased primary fibrinogenolysis is not rare in liver disease, but poorly correlates with liver function.

An Experiments Study for Usage of Urokinase in Treatment of Intracerebral Hematoma

Thrombolysis using urokinase solution is one of the effective methods in treatment of intracerebral hematoma. The present study was undertaken in order to 1) determine the most effective concentration of urokinase solution, 2) determine the most suitable time interval of irrigation of urokinase solution through the measurement of hemoglobin and FDP(Fibrin / Fibrinogen Degradation Product) of drained solution, 3) estimate the size of unresolved hematoma without taking brain CT. The results are summarized as follows : 1) The most effective and economic concentration of urokinase solution was 1000 u/ml. 2) The most preferable time interval of irrigation of urokinase solution was about one hour. 3) It was possible to estimate the size of unresolving hematoma by means of measurement of hemoglobin and hematocrit of patient, hemoglobin and volume of the thrombolysed solution, so that it was unnecessary to take brain CT for measurement of remaining hematoma.