Forecasting thrombotic complications in patients with community acquired pneumonia according to multidimensional analysis of severity, systematic inflammation, endothelial function and hemostasis

T. Pertseva, K. Bielosludtseva, M. Krykhtina
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引用次数: 2

Abstract

BACKGROUND. Despite the significant progress in the diagnostic and treatment of community-acquired pneumonia (CAP), the issues of timely defining thrombotic complications of CAP and their timely treatment have not yet been fully resolved. OBJECTIVE. To determine the prognostic signs of the risk of thrombotic complications in patients with CAP. MATERIALS AND METHODS. Thus, 45 patients with CAP of the 3rd and 4th clinical groups were examined. The result of the cluster analysis was the distribution of patients into certain clusters (classes). There were 3 clusters of patients depending on the predisposition to thrombosis. RESULTS AND DISCUSSION. Patients belonging to cluster 2 and cluster 3 had a high risk of thrombosis. A feature of these patients was a severe course of CAP (by SMRT-CO scale), accompanied by significant leukocytosis or leukopenia in combination with severe systemic inflammation (C-reactive protein) and low protein C. CONCLUSIONS. This category of patients should consider the possibility of prescribing anticoagulant therapy. While in patients with mild CAP, less pronounced systemic inflammation and high levels of protein C, the risk of thrombosis will be low. Therefore, this category of patients will not require the appointment of anticoagulants.
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根据严重程度、全身炎症、内皮功能和止血的多维分析预测社区获得性肺炎患者血栓性并发症
背景。尽管在社区获得性肺炎(CAP)的诊断和治疗方面取得了重大进展,但及时确定CAP的血栓性并发症及其及时治疗的问题尚未完全解决。目标。确定CAP患者血栓性并发症风险的预后体征。材料和方法。因此,我们对第3和第4临床组45例CAP患者进行了检查。聚类分析的结果是患者在特定聚类(类)中的分布。根据血栓形成的易感性,患者可分为3组。结果和讨论。属于第2类和第3类的患者血栓形成的风险较高。这些患者的一个特征是严重的CAP病程(根据SMRT-CO量表),伴有明显的白细胞增多或白细胞减少,并伴有严重的全身炎症(c反应蛋白)和低蛋白c。这类患者应考虑处方抗凝治疗的可能性。而对于轻度CAP患者,不太明显的全身性炎症和高水平的蛋白C,血栓形成的风险将很低。因此,这类患者不需要预约抗凝剂。
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