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RESUMEN Introducción: La infección por SARS-CoV-2 puede aumentar el riesgo de trombosis. Estudios asocian niveles de dímero D con mortalidad por COVID-19. Objetivo: Determinar la capacidad pronostica del dimero D en la predicción de mortalidad por COVID-19 en pacientes hospitalizados en la Unidad de Cuidados Intensivos. Métodos: Se realizó un estudio de cohorte retrospectiva en el Centro Médico Naval durante enero-julio de 2021. Se incluyeron 324 pacientes adultos con COVID-19 confirmada por RT-PCR. Se midieron niveles de dímero D al ingreso utilizando turbidimetría de coagulación (Sysmex CS-5100). Se analizaron variables sociodemográficas, comorbilidades y datos clínicos. El análisis estadístico se realizó con SPSS versión 26, empleando pruebas Chi cuadrado, exacta de Fisher, U de Mann Whitney, COR y regresión de Cox. Resultados: Se determinó un punto de corte de 1,40 µg/mL para los valores de dimero D con una sensibilidad de 80,9%, una especificidad de 86,4% y área bajo la curva (AUC) de 0,916 (IC 95%: 0,884 - 0,947; p =0,016) para predecir mortalidad por COVID-19. Asimismo, se encontró que pacientes con valores de dimero D mayores o iguales a 1,40 µg/mL tenian un riesgo incrementado de fallecimiento en pacientes con COVID-19 (HRa = 6,545; IC 95%: 3,867 - 11,077; p<0,001), independientemente de las variables edad, diabetes mellitus, hipertensión arterial, cardiopatía isquémica, enfermedad cerebrovascular, fibrilación auricular, enfermedad pulmonar obstructiva crónica, asma, cáncer y trombocitopenia. Conclusión: El presente estudio mostró que los niveles de dimero D al ingreso representan un biomarcador fiable en la evaluación del pronostico de pacientes con COVID-19.
ABSTRACT Introduction: SARS-CoV-2 infection can increase the risk of thrombosis. Studies associate D-dimer levels with COVID-19 mortality. Objective: To determine the prognostic capacity of D-dimer in predicting COVID-19 mortality in patients hospitalized in the Intensive Care Unit. Methods: A retrospective cohort study was conducted at the Naval Medical Center from January to July 2021. A total of 324 adult patients with RT-PCR confirmed COVID-19 were included. D-dimer levels were measured upon admission using coagulation turbidimetry (Sysmex CS-5100). Sociodemographic variables, comorbidities, and clinical data were analyzed. Statistical analysis was performed using SPSS version 26, employing Chi-square tests, Fisher's exact test, Mann-Whitney U test, ROC, and Cox regression. Results: A cut-off point of 1.40 µg/mL for D-dimer values was determined, with a sensitivity of 80.9%, specificity of 86.4%, and an area under the curve (AUC) of 0.916 (95% CI: 0.884 - 0.947; p=0.016) for predicting COVID-19 mortality. Additionally, patients with D-dimer values greater than or equal to 1.40 µg/mL had an increased risk of death (adjusted HR = 6.545; 95% CI: 3.867 - 11.077; p<0.001), independent of age, diabetes mellitus, arterial hypertension, ischemic heart disease, cerebrovascular disease, atrial fibrillation, chronic obstructive pulmonary disease, asthma, cancer, and thrombocytopenia. Conclusion: This study showed that admission D-dimer levels represent a reliable biomarker in evaluating the prognosis of COVID-19 patients. Keywords: COVID-19; SARS-CoV-2; Mortality; Fibrin-Fibrinogen Degradation Products (Source: MeSH NLM).
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Resumen Introducción: Un espectro de enfermedad hemorrágica intracraneal se puede presentar con síntomas neurológicos focales transitorios; aunque las enfermedades congénitas del fibrinógeno son inusuales y rara vez se manifiestan de esta manera, a continuación se presenta un caso de microsangrados cerebrales por hipofibrinogenemia congénita con síntomas neurológicos focales transitorios. Presentación del caso: Paciente masculino de 29 años de edad con microsangrados cerebrales por hipofibrinogenemia congénita con síntomas neurológicos focales transitorios. Discusión: La hemorragia intracerebral de vasos pequeños es una causa de síntomas neurológicos focales transitorios. La prevalencia de microhemorragias cerebrales en la población adulta mayor es un problema altamente reconocido, sin embargo, la incidencia de estos microsangrados en personas más jóvenes es baja y desconocida. Las discrasias sanguíneas, como el trastorno hereditario del fibrinógeno, son una causa de anomalías hereditarias de la coagulación sanguínea, donde este tiene una función importante en el control del sangrado por agregación plaquetaria y en la cascada de coagulación. La ausencia de fibrinógeno normal conduce a una altercación en la hemostasia y, por tanto, a complicaciones hemorrágicas. Conclusiones: Los síntomas neurológicos focales transitorios pueden ser causados por una enfermedad vascular cerebral hemorrágica de vasos pequeños, donde las discrasias sanguíneas congénitas son una causa rara de este tipo de enfermedad cerebrovascular.
Abstract Introduction: Intracranial hemorrhagic disease can present with transient focal neurological symptoms. Congenital fibrinogen diseases are unusual and can rarely manifest in this way. Below we present a case of cerebral microbleeds due to congenital hypofibrinogenemia with transient focal neurological symptoms. Case presentation: This is a 29-year-old man with cerebral microbleeds due to congenital hypofibrino-genemia with transient focal neurological symptoms. Discussion: Cerebral microbleed and intracerebral hemorrhage is a cause of transient focal neurological symptoms. The prevalence of cerebral microbleeds in the elderly population is a highly recognized problem. However, the incidence of these microbleeds in younger people is low and unknown. Blood dyscrasias, such as inherited fibrinogen disorder, are a cause of inherited abnormalities of blood clotting. Fibrinogen has an important role in the control of bleeding due to platelet aggregation and is part of the coagulation cascade. The absence of normal fibrinogen induces alteration in platelet and coagolation hemostasis and, therefore, causes hemorrhagic complications. Conclusions: Transient focal neurological symptoms may be caused by small vessel hemorrhagic cere-brovascular disease. Congenital blood dyscrasias are a rare cause of this type of cerebrovascular disease.
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Objective:To investigate the correlation between plasma fibrinogen/serum albumin ratio (FAR) and the degree of cerebral artery stenosis in patients with acute cerebral infarction (ACI).Methods:Clinical data of 189 patients with acute cerebral infarction diagnosed and treated in the Department of Neurology of the First Affiliated Hospital of Hainan Medical College from January 2021 to March 2023 were selected for retrospective analysis. Digital subtraction angiography (DSA) was improved, and they were divided into four groups according to the degree of intracranial vascular stenosis according to NASCET grading method: no stenosis group (47 cases), mild stenosis group (45 cases), moderate stenosis group (39 cases) and severe stenosis and occlusion group (58 cases). The differences of basic data, plasma fibrinogen/serum albumin ratio (FAR) and other inflammatory indicators among all groups were compared, and the correlation between FAR level and the severity of cerebral artery stenosis was analyzed. Multivariate Logistic regression was used to explore the factors influencing to cerebral artery stenosis and ROC curve was used to evaluate the diagnostic value of FAR in the degree of cerebral artery stenosis in cerebral infarction patients.Results:There were significant differences in blood neutrophil (NEU), mean platelet volume (MPV), fibrinogen (FIB), fibrinogen (FIB), albumin (ALB) and FAR among the 4 groups (statistical values were H=11.50, H=8.44, F=5.16, H=30.93, H=40.38; all P<0.05). Correlation analysis showed a positive correlation between FAR and the degree of cerebral artery stenosis ( r=0.455, P<0.05). Multivariate Logistic regression showed that FAR was an independent risk factor for the degree of cerebral artery stenosis ( OR=1.445, 95% CI=1.261-1.655, P<0.001). Conclusion:FAR is an independent risk factor for cerebral artery stenosis in patients with acute cerebral infarction (ACI), and may be a new biomarker for predicting cerebral artery stenosis.
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Objective:To investigate the relationship between preoperative plasma fibrin degradation products (FDP) level and clinicopathological features of patients with completely resected non-small cell lung cancer (NSCLC).Methods:A retrospective case series study was performed. The clinical data of 521 patients who were pathologically diagnosed with NSCLC in Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to December 2017 were retrospectively analyzed. Among 521 cases, 406 cases were postoperatively pathologically confirmed as non-lymph node and non-distant metastasis (non-metastasis group) and 115 cases were postoperatively pathologically confirmed as lymph node or distant metastasis (metastasis group). The preoperative FDP level and clinicopathological characteristics as well as the clinicopathological characteristics of NSCLC patients with different FDP levels were compared between the two groups. The correlation between preoperative FDP level and TNM staging was analyzed by using Spearman correlation analysis.Results:Among 521 NSCLC patients, 266 cases were female, 255 cases were male; the age [ M( Q1, Q3)] was 59 years (54 years, 65 years); 441 cases were adenocarcinoma and 70 cases were squamous cell carcinoma. The preoperative median FDP level was 2.78 mg/L (2.35 mg/L, 3.13 mg/L) and 2.99 mg/L (2.56 mg/L, 4.16 mg/L), respectively of NSCLC patients in non-metastasis group and metastasis group, and the difference was statistically significant ( Z = 6.13, P < 0.001). The preoperative FDP level was 2.56 mg/L (2.35 mg/L, 3.20 mg/L) and 2.99 mg/L (2.56 mg/L, 3.20 mg/L), respectively in the early-stage NSCLC (stage Ⅰ-Ⅱ) and advanced NSCLC (stage Ⅲ-Ⅳ) patients, and the difference was statistically significant ( Z = 8.42, P < 0.001). Spearman correlation analysis showed that preoperative FDP level was positively correlated with tumor diameter ( r = 0.287, P < 0.001). There was a positive correlation between preoperative FDP level and the number of metastatic lymph nodes in 115 patients with lymph node metastasis ( r = 0.679, P < 0.001). According to the preoperative median FDP (2.78 mg/L), all patients were divided into FDP ≤2.78 mg/L group and FDP >2.78 mg/L, and there were statistically significant differences in age, metastasis, tumor staging, tumor diameter, the metastatic number of lymph node and histological types of NSCLC patients in both groups (all P < 0.05). Conclusions:The increase of preoperative plasma FDP level may be related to the tumor metastasis and clinical stage of NSCLC patients
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【Objective】 To study and compare the effects of different storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor(CAF) melting, and to provide reference for the establishment of industry standards. 【Methods】 From June 2021 to May 2023, a total of 96 bags of CAF were sampled in 4 bags per month, and timely detected in the same month. After the CAF was melted in a 37℃ water bath, the mild to moderate lipemic blood was labeled. Each bag of CAF and two 50 mL transfer bags were divided into two bags and two groups of 20 mL each using a sterile adapter. One group was placed in a 4℃ refrigerator and the other in a 22℃ water bath for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h. Then 2 mL of aseptic sample was taken separately and put into the test tube, and 1mL of sample and 3 mL of buffer were added into the other test tube with the sampling gun and mixed on the machine for testing. The experimental data of 60 bags without mild to moderate lipemic blood cryoprecipitation and coagulation factor were randomly selected and statistically analyzed by SPSS21.0. 【Results】 After melting, CAF was stored for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h to detect the average content and growth rate of coagulation factor in the two groups: 1) Storage at 4℃, factor Ⅷ content was 118.62, 111.57(-5.95%), 105.51(-11.05%), 103.30(-12.92%), 94.35(-20.46%) and 83.25(-29.82%) IU/ bag, respectively; Storage at 22℃, the factor Ⅷ content was 118.62, 112.69(-5.00%), 111.41(-6.08%), 109.01(-8.10%), 101.55(-14.39%) and 92.75(-21.81%) IU/ bag, and the storage results of the two groups were compared. At 24 h at 4℃ and 48 h at 22℃, the content of factor Ⅷ had significant statistical significance(P0.05). 【Conclusion】 After CAF melting, coagulation factor decreased with the extension of storage time, especially the decrease of factor Ⅷ, followed by factor V, while Fbg basically unchanged. Comparison between the two groups showed that, factor Ⅷ decay rate is slower, factor V decay rate is faster of storage at 22℃. CAF should be transfused as soon as possible after melting. If the delay is unavoidable, for the delay time less than 12 h, storage at 4℃ is recommended, fot the delay time more than 12 h and less than 24 h, storage at 22℃ is recommended.
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Objective: Little is known about the coagulation activity of factor XIII (FXIII) during resuscitation for hemorrhagic shock and the effects of plasma transfusions. We performed a single-center observational study to evaluate the changes in FXIII activity during resuscitation for hemorrhagic shock.Patient and Methods: Twenty-three adult patients with hemorrhagic shock were enrolled in this study. Blood samples were drawn upon arrival (T1), at the time of hemostasis completion (T2), and on day 2 (T3). Baseline and changes in FXIII activity and the proportion of patients with adequate levels of FXIII activity (FXIII activity >70%) were evaluated. The effects of plasma transfusion on these parameters were also investigated.Results: At T1, the median (interquartile range) FXIII activity was 53% (47–85%), which did not increase (T1 vs. T3: 53% [47–85%] vs. 63% [52–70%], P=0.8766). The proportion of patients with adequate FXIII activity decreased throughout the resuscitation period (T1, T2, and T3: 30, 34, and 21%, respectively). Plasma transfusion did not affect FXIII activity (T1 vs. T2, 66.4% [23.4] vs. 70.0% [16.2%], P=0.3956; T2 vs. T3, 72.0% [19.5] vs. 63.5% [8.6%], P=0.1161) or the proportion of adequate levels of FXIII activity at 44% at T2 and 27% at T3.Conclusion: FXIII activity is low during the early phase of a hemorrhagic shock. Even with plasma transfusion, FXIII levels were not adequately maintained throughout resuscitation.
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Objective:To analyze the application value of thromboelastography (TEG) in the prediction of lower limb deep vein thrombosis (DVT) after high-energy ankle injury surgery.Methods:The clinical data of 62 patients undergoing high-energy ankle injury surgery who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2021 were retrospectively analyzed. Based on the occurrence of lower limb DVT, the patients were divided into a control group (without lower limb DVT, n = 42) and an observation group (with lower limb DVT, n = 20). The conventional coagulation function indicators and TEG parameters were compared between the two groups. The receiver operating characteristic (ROC) curves were used to investigate the value of classic coagulation function indicators and TEG parameters in the prediction of lower limb DVT after high-energy ankle injury surgery. Results:The activated partial thromboplastin time in the observation group was (33.29 ± 3.40) seconds, which was significantly shorter than (35.66 ± 3.36) seconds in the control group ( t = 2.59, P < 0.05). The levels of fibrinogen and D-dimer in the observation group were (3.83 ± 0.46) g/L and (1.77 ± 0.43) g/L, respectively, which were significantly higher than (3.47 ± 0.51) g/L and (1.56 ± 0.35) g/L, respectively, in the control group ( P = -2.68, -.05, both P < 0.05). Prothrombin time and thrombin time showed no significant differences between the two groups (both P > 0.05). Coagulation reaction time and cell agglutination formation time in the observation group were (3.80 ± 0.83) minutes and (3.38 ± 0.51) minutes, respectively, which were significantly lower than (4.49 ± 1.21) minutes and (3.82 ± 0.55) minutes in the control group ( t = 2.30, 2.96, both P < 0.05). The maximum clot strength and coagulation rate (α angle) in the observation group were (78.69 ± 9.22) mm and (83.37 ± 9.30) °, respectively, which were significantly greater than (68.33 ± 9.10) mm and (71.25 ± 8.35) ° in the control group ( t = -4.17, -5.15, both P < 0.05). The ROC curve analysis found that the area under the ROC curve describing the prediction of combined indexes for lower limb DVT was 0.983, which was significantly greater than the area under the ROC curve describing the prediction of a single index for lower limb DVT (all P < 0.05). Conclusion:Activated partial thromboplastin time, fibrinogen, D-dimer, coagulation reaction time, red blood cell agglutination formation time, maximum clot strength, and α angle are significantly different between patients with DVT in the lower limb after surgery for an ankle injury and those without DVT. The combination of these indicators can serve as the basis for preventing and treating thrombosis in patients after high-energy ankle injury surgery, demonstrating remarkable practical advantages.
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Objective:To evaluate the clinical efficacy of individualized thrombolysis-assisted comprehensive intervention for deep vein thrombosis (DVT) in the lower limbs.Methods:This study included 32 patients with acute lower limb DVT diagnosed by angiography who received treatment at the Jianhu Clinical Medical College of Yangzhou University from March 2012 to November 2021. These patients first received implantation of an inferior vena cava filter. Then they were divided into a control group and an observation group based on treatment methods. The control group received thrombolytic catheterization and a routine infusion of urokinase. In the observation group, balloon dilation was performed first, and a large lumen catheter was used to draw blood clots. Subsequently, urokinase at a dose based on fibrinogen measurement was injected through a thrombolytic catheter. Swelling reduction, venous patency, and complications of the affected limbs were monitored.Results:In the control group, the difference in thigh circumference before treatment was (4.65 ± 1.06) cm, and after treatment, it was (2.76 ± 1.25) cm. In the observation group, the difference in thigh circumference before treatment was (4.73 ± 1.03) cm, and it was (1.40 ± 0.83) cm after treatment. In the control group, the difference in calf circumference before treatment was (2.24 ± 0.90) cm, and it was (1.56 ± 0.86) cm after treatment. In the observation group, the difference in calf circumference before treatment was (2.40 ± 0.83) cm, and it was (0.80 ± 0.73) cm after treatment. After treatment, the differences in thigh circumference and calf circumference between the healthy and affected sides were statistically significant ( t = 3.58, 2.67, both P < 0.05). After treatment, there was a significant difference in venous patency between the control and observation groups (34.02% [33/97] vs. 68.18% [60/88], t = 3.44, P < 0.05). After 12 months of follow-up, the Villalta scale score, which was used to evaluate post-thrombotic syndrome, was (9.23 ± 4.07) points in the control group, which was significantly different from (5.73 ± 3.39) points in the observation group ( t = 2.62, P < 0.05). Conclusion:Individualized thrombolysis-assisted comprehensive intervention is highly effective in the treatment of DVT in the lower limbs and results in few complications.
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Objective To investigate the influence and predictive value of systemic immune inflammation(SII),fibrinogen(Fib)and triglyceride glucose index(TyG)on the risk of diabetic kidney disease(DKD).Methods A total of 1073 patients with type 2 diabetes mellitus(T2DM)admitted to The Endocrinology Department of Hebei Yiling Hospital Affiliated to Hebei Medical University were enrolled in this study from January 2020 to December 2022.All the patients were divided into two groups according to the urinary protein creatinine ratio:DKD group(UACR≥30 mg/g,DKD,n=412)and simple T2DM group(UACR<30 mg/g,T2DM,n=661).Pearson correlation analysis was used to evaluat the correlation between SII,TyG,Fib and other indicators.Multiple logistic regression analysis was used to find the influencing factors for DKD.The clinical value of Fib,SII,TyG,and combined indicators in diagnosing DKD was tested by receiver operating characteristic(ROC)curve analysis.Results Compared with T2DM group,age,duration of DM,FPG,TG,TyG,cystatin C(CysC),glutamyl transpeptidase,SUA,homocysteine,SII,neutrophil count,Fib and D-D were increased(P＜0.05 or P＜0.01),while albumin(ALB)and HDL-C were decreased(P＜0.05 or P＜0.01)in DKD group.Pearson correlation analysis showed that SII was positively correlated with CysC,Scr,SUA,Fib,FDP,and D-D(P＜0.05 or P＜0.01),and negatively correlated with eGFR,ALB(P＜0.01);TyG is positively correlated with SUA(P＜0.01);Fib is positively correlated with CysC,Scr(P＜0.01),and negatively correlated with eGFR(P＜0.01).Multiple logistic regression analysis showed that TyG and Fib were the influencing factors for DKD.The ROC curve analysis showed that the area under the ROC curve for the combined index was 0.679,with a specificity of 74.2%,a sensitivity of 53.5%,and an optimal cutoff value of 0.276.Conclusion SII and Fib can directly cause renal function damage in DKD,while IR promotes DKD progression through metabolic disorders.The combined predictive value of Fib,SII,and TyG for DKD risk is superior to a single indicator.
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@#Objective To investigate the risk factors associated with clinical stage in patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 182 patients with non-small cell lung cancer admitted from July 2019 to March 2023 were retrospectively analyzed,and they were divided into stage Ⅰ,stage Ⅱ group(n=73)and stage Ⅲ,stage Ⅳ group(n=109)according to the clinical stage.Inter-group comparison and Logistic regression analysis were used to screen the risk factors affecting the clinical stage of patients,and receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of these risk factors.Results Antinuclear antibody(ANA),fibrinogen(FIB)and cytokeratin 19 fragment(CYFRA21-1)were independent risk factors affecting the clinical stage of NSCLC patients.The optimal cut-off values of FIB and CYFRA21-1 were 4.07g/L and 7.07μg/L,respectively.The area under curve(AUC)of the combined diagnosis of clinical stage was 0.859,the sensitivity was 64.2％,and the specificity was 95.9％.Conclusion ANA,FIB and CYFRA21-1 are independent risk factors for the progression of clinical stage of NSCLC patients.The combined detection of the three indicators has certain reference value for the diagnosis of clinical stage in NSCLC patients.
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ABSTRACT Introduction: Inflammatory and immunological factors play pivotal roles in the prognosis of acute type A aortic dissection. We aimed to evaluate the prognostic values of immune-inflammatory parameters in acute type A aortic dissection patients after surgery. Methods: A total of 127 acute type A aortic dissection patients were included. Perioperative clinical data were collected through the hospital's information system. The outcomes studied were delayed extubation, reintubation, and 30-day mortality. Multivariate logistic regression analysis and receiver operating characteristic analysis were used to screen the risk factors of poor prognosis. Results: Of all participants, 94 were male, and mean age was 51.95±11.89 years. The postoperative prognostic nutritional indexes were lower in delayed extubation patients, reintubation patients, and patients who died within 30 days. After multivariate regression analysis, the postoperative prognostic nutritional index was a protective parameter of poor prognosis. The odds ratios (95% confidence interval) of postoperative prognostic nutritional index were 0.898 (0.815, 0.989) for delayed extubation and 0.792 (0.696, 0.901) for 30-day mortality. Low postoperative fibrinogen could also well predict poor clinical outcomes. The odds ratios (95% confidence interval) of postoperative fibrinogen were 0.487 (0.291, 0.813) for delayed extubation, 0.292 (0.124, 0.687) for reintubation, and 0.249 (0.093, 0.669) for 30-day mortality. Conclusion: Postoperative prognostic nutritional index and postoperative fibrinogen could be two promising markers to identify poor prognosis of acute type A aortic dissection patients after surgery.
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ABSTRACT Respiratory syncytial virus (RSV) is a common cause of respiratory infections. It is responsible for more than half of lower respiratory tract infections in infants requiring hospitalization. This study aimed to investigate the correlation between the fibrinogen-albumin ratio (FAR) and the severity of RSV infection and to compare its effectiveness with the neutrophil-lymphocyte ratio (NLR). This was a retrospective cohort study with patients aged from 29 days to two years who had been admitted to the pediatric clinic of our hospital. Patients were divided into four groups: group 1 (mild disease), group 2 (moderate disease), group 3 (severe disease), and group 4 (control). FAR and NLR were measured in all groups. FAR was significantly higher in group 3 than in the other groups, in group 2 than in groups 1 and 4, and in group 1 than in group 4 (p<0.001 for all). NLR was significantly higher in group 4 than in the other groups and in group 3 than in groups 1 and 2 (p<0.001 for all). FAR totaled 0.078 ± 0.013 in patients with bronchiolitis; 0.099 ± 0.028, in patients with bronchopneumonia; and 0.126 ± 0.036, in patients with lobar pneumonia, all with statistically significant differences (p<0.001). NLR showed no significant statistical differences. This study found a statistically significant increase in FAR in the group receiving invasive support when compared to that receiving non-invasive support (0.189 ± 0.046 vs. 0.112 ± 0.030; p=0.003). Mechanical ventilation groups showed no differences for NLR. FAR was used to identify severe RSV-positive patients, with a sensitivity of 84.4%, a specificity of 82.2%, and a cutoff value of >0.068. This study determined a cutoff value of ≤1.49 for NLR, with a sensitivity of 62.2% and a specificity of 62.2% to find severe RSV-positive patients. Also, statistically significant associations were found between FAR and hospitalization and treatment length and time up to clinical improvement (p<0.001 for all). NLR and hospitalization and treatment length showed a weak association (p<0.001). In children with RSV infection, FAR could serve to determine disease severity and prognosis and average lengths of hospitalization, treatment, and clinical improvement. Additionally, FAR predicted disease severity more efficiently than NLR.
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Abstract Objective: To determine whether peripheral blood parameters have any predictive value for all-frequency Sudden Sensorineural Hearing Loss (SSNHL). Methods: We chose 78 individuals with all-frequency SSNHL who had been admitted to our department. They were divided into two groups: the effective group and the ineffective group. In patients with all-frequency SSNHL, the prognostic variables, including peripheral blood tests and clinical traits, were examined by a logistic regression analysis. In addition, the predictive value was carried out. Results: The effective rate of all-frequency SSNHL was 61.5%. Pre-treatment hearing level and the proportion of patients with diabetes were both significantly lower in the effective group than in the ineffective group (p = 0.024 and 0.000, respectively). The levels of fibrinogen and C-reactive protein were also significantly different between the two groups (p = 0.001 and 0.025, respectively). Pre-treatment hearing level and fibrinogen level both significantly impacted the prognosis of all-frequency SSNHL (p = 0.032 and 0.002, respectively), according to a logistic regression analysis. Furthermore, the prognosis was significantly predicted by both fibrinogen level and pre-treatment hearing level (p = 0.001 and 0.0002, respectively). The receiver operating characteristic curve showed that the fibrinogen level had a sensitivity of 85.4% and a specificity of 60.0% for predicting the prognosis of all-frequency SSNHL. Conclusion: For the prognosis of all-frequency SSNHL, the fibrinogen level can be regarded as a useful predictor. The level of C-reactive protein, however, does not have a significant prognostic effect on predicting all-frequency SSNHL. Therefore, more attention should be devoted to the level of fibrinogen in the acute period of all-frequency SSNHL. Level of Evidence: 4.
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Background: Fibrinogen is a glycoprotein produced by the liver that plays a crucial role in blood clotting. Elevated levels of fibrinogen have been associated with an increased risk of cardio vascular disease, stroke and other chronic conditions. Several studies have investigated the relationship between fibrinogen and diabetes mellitus. Furthermore, fibrinogen has been suggested to play a role in pathogenesis of diabetes and its complications by promoting inflammation and endothelial dysfunction. The aim of the study was done to study association of fibrinogen levels and development of complications of diabetes mellitus. Methods: A cross sectional observational study was conducted at medicine department of Dhiraj Hospital, Vadodara. Total of 114 diabetes mellitus patients were studied. The level of fibrinogen as well as presence of various risk factors like smoking, hypertension, obesity, dyslipidemia and different microvascular and macro-vascular complications were assessed. There were no conflict of interest. Results: Of 114 patients smoking, overweight, hypertension, uncontrolled diabetes and dyslipidemia was reported in 54.4%, 30.7%, 41.2%, 28.1% and 60.5% respectively. Microvascular complication like retinopathy, nephropathy and neuropathy was reported in 34.2%, 40.4% and 21.1% patients respectively. Macrovascular complications like coronary artery disease and stroke was reported in 20.2% and 16.7% patients respectively. Average level of fibrinogen was found higher amongst diabetic patients with microvascular as well as macrovascular complications. Conclusions: Serum fibrinogen level was found to be higher among patients with poor glycemic control, dyslipidemia, hypertension and higher BMI. A positive correlation was found between the level of fibrinogen and various complications of diabetes mellitus.
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Background: Fibrinogen is a glycoprotein produced by the liver that plays a crucial role in blood clotting. Elevated levels of fibrinogen have been associated with an increased risk of cardio vascular disease, stroke and other chronic conditions. Several studies have investigated the relationship between fibrinogen and diabetes mellitus. Furthermore, fibrinogen has been suggested to play a role in pathogenesis of diabetes and its complications by promoting inflammation and endothelial dysfunction. The aim of the study was done to study association of fibrinogen levels and development of complications of diabetes mellitus. Methods: A cross sectional observational study was conducted at medicine department of Dhiraj Hospital, Vadodara. Total of 114 diabetes mellitus patients were studied. The level of fibrinogen as well as presence of various risk factors like smoking, hypertension, obesity, dyslipidemia and different microvascular and macro-vascular complications were assessed. There were no conflict of interest. Results: Of 114 patients smoking, overweight, hypertension, uncontrolled diabetes and dyslipidemia was reported in 54.4%, 30.7%, 41.2%, 28.1% and 60.5% respectively. Microvascular complication like retinopathy, nephropathy and neuropathy was reported in 34.2%, 40.4% and 21.1% patients respectively. Macrovascular complications like coronary artery disease and stroke was reported in 20.2% and 16.7% patients respectively. Average level of fibrinogen was found higher amongst diabetic patients with microvascular as well as macrovascular complications. Conclusions: Serum fibrinogen level was found to be higher among patients with poor glycemic control, dyslipidemia, hypertension and higher BMI. A positive correlation was found between the level of fibrinogen and various complications of diabetes mellitus.
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Objective@# To investigate the plasma levels of interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer (D-D) and fibrinogen (Fib) among patients with pneumoconiosis, so as to provide insights into the prevention of thrombosis among patients with pneumoconiosis.@*Methods@#Ninety-six male coal workers with stable-stage pneumoconiosis admitted to China Pingmei Shenma Group Occupational Disease Prevention and Control Hospital from February 2019 to February 2021 were included in the pneumoconiosis group, and 43 male healthy volunteers in the hospital during the same period were selected as the control group. The plasma D-D, Fib, IL-6 and CRP levels were detected from subjects in the two groups. The associations of plasma D-D and Fib levels with IL-6 and CRP levels were examined using Pearson correlation analysis among pneumoconiosis patients. @*Results@#Participants in the pneumoconiosis group and the control group had a mean age of (52.91±3.89) and (52.64±4.12) years, D-D of (1.28±0.91) and (0.44±0.11) mg/L, Fib of (4.41±0.98) and (2.88±0.61) g/L, IL-6 of (0.63±0.19) and (0.42±0.06) ng/L and CRP of (3.30±1.65) and (1.35±0.12) mg/L, respectively. Higher plasma D-D, Fib, IL-6 and CRP levels were detected in the pneumoconiosis group than in the control group (all P<0.05). The plasma D-D level correlated positively with IL-6 level among pneumoconiosis patients (r=0.347, P<0.001). @*Conclusion@#High plasma IL-6, CRP, D-D and Fib levels are detected among patients with pneumoconiosis, and the plasma D-D level correlates positively with IL-6 level among patients with pneumoconiosis.
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Objective:To explore the differential diagnosis value of preoperative D-dimer in renal oncocytoma (RO) and chromophobe renal cell carcinoma (Ch-RCC) .Methods:From January 2015 to April 2022 in the Second Hospital of Anhui Medical University, clinical data of 47 cases of rare renal tumors were collected. According to postoperative pathology, patients were divided into RO group (15 cases) and Ch-RCC group (32 cases). General clinical data and preoperative blood indicators were analyzed. Receiver operator characteristic (ROC) curve and area under the curve (AUC) were performed to evaluate the differential diagnosis value of D-dimer between RO and Ch-RCC.Results:There were no significant differences between two groups in gender ( χ2=0.41, P=0.522), age ( t=0.50, P=0.618), hypertension ( χ2<0.01, P=0.994), diabetes ( P=0.541), smoking history ( χ2=1.67, P=0.196), tumor laterality ( χ2=0.67, P=0.414). Besides, preoperative D-dimer was significantly higher in the Ch-RCC group [0.47 (0.29, 0.77) μg/ml] in comparison with RO group [0.21 (0.19, 0.27) μg/ml], with a statistically significant difference ( Z=4.44, P<0.001). In addition, there were no significant differences in hemoglobin ( t=-1.61, P=0.116), platelet ( t=0.26, P=0.800), leucocyte ( t=0.10, P=0.921), neutrophil ( t=-0.87, P=0.390), lymphocyte ( Z=0.82, P=0.418), monocyte ( Z=1.43, P=0.153), neutrophil-lymphocyte ratio ( Z=0.09, P=0.927), platelet-lymphocyte ratio ( t=0.42, P=0.676), and lymphocyte-monocyte ratio ( Z=-0.96, P=0.338) between Ch-RCC group and RO group. ROC curve analysis showed that when the cut-off value of preoperative D-dimer was 0.78 μg/ml, the AUC for differential diagnosis of RO and Ch-RCC was 0.90 (95% CI: 0.82-0.99, P<0.001), with a sensitivity of 0.78 and a specificity of 1.00. Conclusion:Preoperative level of D-dimer is significantly increased in Ch-RCC patients, which exhibits favourable preoperative differential diagnosis value between Ch-RCC and RO.
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Background:With the improvement of national health awareness and the popularization of a series of screening methods,the number of early colorectal cancer is gradually increasing,accurate prediction of lymph node metastasis of T1 colorectal cancer is the key to determine the optimal therapeutic solutions.Aims:To investigate the relationship between preoperative inflammatory markers,fibrinogen,apolipoprotein B and lymph node metastasis in patients with early colorectal cancer.Methods:The clinical data of 102 patients with early colorectal cancer who received surgical treatment in the Department of General Surgery,Affiliated Hospital of Jiangsu University from January 2014 to December 2022 were retrospectively analyzed.The patients were divided into positive lymph node group and negative lymph node group according to postoperative pathological results.Univariate and multivariate Logistic regression analysis were employed to explore the correlation between lymph node metastasis and clinical test parameters in early colorectal cancer.Results:A total of 102 patients in T1 colorectal cancer were enrolled in this study,including 53 males and 49 females,and the mean age was(64±10)years.Postoperative pathological diagnosis of lymph node metastasis was 13 cases and no lymph node metastasis was 89 cases.The univariate analysis showed that age,fibrinogen and apolipoprotein B-monocyte ratio(AMR)were related to lymph node metastasis in early colorectal cancer(P<0.05).The multivariate Logistic regression analysis showed that age,fibrinogen and AMR were independent predictors of lymph node metastasis.Conclusions:The age,fibrinogen and AMR may play an important role in predicting lymph node metastasis in early colorectal cancer.They can be combined with pathological factors to further create a new prediction model,so as to provide some reference for patients in colorectal cancer to choose the therapeutic regimen.
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@#Objective The aim of this study was to analyze the relationship between serum fibrinogen to albumin ratio(FAR) and the main types of ischemic cerebrovascular disease(IVD):lacunar infarction(LI) and transient ischemic attack(TIA) before treatment. Methods Two hundreds and twenty-six IVD patients who were admitted to our hospital from January 2018 to November 2021 were collected,including 109 in Li group and 117 in TIA group. According to the average value of FAR,the two groups were divided into LILow FAR group(≤0.11,n=61),LI High FAR group(>0.11,n=48),TIA Low FAR group(≤0.11,n=68) and TIA High FAR group respectively(>0.11,n=49);Thirty-three healthy patients in the same period were selected as the control group. Pre-treatment FAR levels were analyzed in the five groups of patients,the FAR levels of the five groups were analyzed,the correlation between FAR levels and LI and TIA was analyzed by multivariate logistic regression,and the predictive value of FAR to LI and TIA was evaluated by ROC curve. Results Compared with the control group and Low FAR group,FAR in LI and TIA groups was increased(P≤0.05). Multivariate logistic regression analysis showed that FAR is an independent risk factor for LI,not for TIA. ROC curve analysis shows that the FAR can be a predictor of LI. Conclusion FAR is an independent risk factor for LI. It has good predictive value for LI,andit can be used as a predictor of LI.
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@#Objective To summarize the clinical characteristics of Trousseau's syndrome with acute multiple cerebral infarction and its correlation with D-polymer and fibrinogen. Methods The clinical characteristics of 31 patients with malignant tumor complicated with cerebral infarction hospitalized from July 2019 to October 2021 were retrospectively analyzed and reviewed. The correlation between NIHSS score and D-polymer and fibrinogen was analyzed. Results The incidence of male was higher than that of female (61.29%),28 cases had multiple lesions (≥2),31 cases had increased D-dimer,19 cases showed fibrinogen abnormality,18 cases of lung cancer (58.06%),3 cases of bowel cancer (9.68%),5 cases of gastric cancer (16.13%),2 cases of cervical cancer (6.45%). There were 3 cases with liver cancer (9.68%),16 cases with metastasis (51.61%),NIHSS score had no significant correlation with D-dimer (0.041),and a certain negative correlation with fibrinogen (-0.162),but there was no significant difference between NIHSS score and NIHSS score (P>0.05). Conclusion For patients with malignant tumors complicated with acute multiple cerebral infarction,Trousseau's syndrome should be considered. At the same time,D-polymer and fibrinogen may be related to ischemic stroke. Anticoagulant therapy can be used as the main treatment method,and fibrinogen reduction therapy may further aggravate neurological deficits.